Practice Question
A nurse is monitoring a client who is receiving continuous IV propofol. Which of the following actions should the nurse take to maintain the client's IV site?
Answer Choices:
Correct Answer:
Change the IV tubing at least every 6 hr.
Rationale:
💉 Propofol is a lipid-based emulsion, which increases the risk for bacterial growth if it hangs too long or the tubing is not frequently changed.
💉 Standard recommendations are to change the IV tubing and solution at least every 6–12 hours when infusing propofol, with many policies specifying q6h for safety.
💉 Frequent tubing changes help reduce the risk of bloodstream infection and contamination at the IV site.
💉 Because the drug is continuous and often used for sedation, meticulous IV care is crucial to maintain asepsis.
💉 Therefore, changing the IV tubing at least every 6 hours is an appropriate action to maintain a safe IV site for propofol infusion.
Change the IV site dressing daily.
💉 IV dressings are not typically changed daily unless they are loose, soiled, or compromised, as frequent changes can disturb the insertion site and increase infection risk.
💉 For many peripheral lines, transparent dressings are changed every 5–7 days per policy, or earlier if needed.
💉 The key issue with propofol is the tubing and solution, not frequent dressing changes, because of the lipid medium that can support microbial growth in the line.
💉 Daily dressing changes are not evidence-based for infection prevention in this context and might cause more site manipulation than needed.
💉 Thus, while the site and dressing should be assessed frequently, automatic daily dressing change is not the main maintenance strategy.
Disconnect the IV tubing when applying the client's gown.
💉 Frequently disconnecting and reconnecting IV tubing increases the risk for contamination and infection, especially with a lipid-based drug like propofol.
💉 Instead, the nurse should thread the tubing carefully through the gown or adjust the gown around the tubing to avoid disconnection.
💉 Every time the system is opened, there is risk of introducing microorganisms into the IV line.
💉 Maintaining a closed system is a key principle of IV therapy safety.
💉 Therefore, disconnecting the tubing for gown changes is not appropriate practice.
Increase the client's IV infusion rate as needed.
💉 The rate of propofol infusion is a prescribed dose based on weight and desired level of sedation and must be managed according to provider orders and sedation protocols.
💉 The nurse should not arbitrarily “increase as needed” just to maintain the IV site; rate changes must be based on clinical status and orders, not line maintenance.
💉 Adjustments in infusion rate can significantly affect cardiovascular and respiratory depression, which are major risks with propofol.
💉 Maintenance of the site focuses on sterility, patency, and proper tubing changes, not unauthorized rate changes.
💉 Hence, increasing the infusion rate “as needed” is unsafe and incorrect.
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This question is from RN PHARMACOLOGY 2023 ✅ which contains 65 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pharmacology
- Answer Choices: 4