Free CRNI® Exam Flashcards

Assess the prescribed therapy, expected duration, vascular history, and available vessels before selecting an access device. The goal is safe therapy delivery while preserving future access.

A device must fit the infusate and treatment plan. Irritant or vesicant therapy, expected duration, and required flow can make a short peripheral catheter inappropriate.

Look for pain or tenderness, erythema, warmth, swelling, or a palpable venous cord along the vein. Assess promptly and follow the organization’s escalation and device-removal policy.

Positioning affects vessel visibility, comfort, and procedural safety. Use the procedure-specific position and adjust for the patient’s clinical condition rather than using one position for every insertion or removal.

Use them for every patient. They include hand hygiene and risk-based personal protective equipment when exposure to blood or body fluids is anticipated.

Keep key parts and key sites from being touched after disinfection. If sterility is compromised, correct it before proceeding.

Perform hand hygiene before and after patient contact and before aseptic tasks. Gloves do not replace hand hygiene.

Every central-line access should use meticulous hand hygiene, aseptic technique, and disinfection of the access point. Preventing contamination is safer than treating a bloodstream infection.

Use the approved antiseptic and allow it to dry completely before access. Scrubbing without adequate drying can undermine the antiseptic step.

Local findings can include insertion-site erythema, tenderness, or drainage. Fever, chills, or hemodynamic changes raise concern for systemic infection and require prompt assessment and escalation.

Inspection helps detect moisture, lifting, drainage, bleeding, inflammation, or device migration. A compromised dressing can increase infection and dislodgement risk.

Break transmission through hand hygiene, aseptic technique, cleaning and disinfection, appropriate PPE, and timely recognition of infection signs.

Prevent contamination: verify the order and patient, use the required antiseptic technique, and collect specimens according to the organization’s protocol before antimicrobial therapy when clinically feasible.

Bedside labeling after patient identification preserves specimen-to-patient accuracy and reduces the risk of a dangerous identification error.

Monitor for dizziness, hypotension, or vasovagal symptoms during and after the prescribed blood removal. Follow the ordered volume, replacement plan, and observation requirements.

Use for appropriate short-term peripheral therapy when the infusate and patient’s veins are suitable. Reassess if the therapy, duration, or vessel condition changes.

A midline is a peripheral device; its tip does not terminate in central circulation. Do not treat it as interchangeable with a central venous access device.

A peripherally inserted central catheter enters through a peripheral vein but terminates in central circulation. It is selected when the therapy and anticipated duration warrant central access.

The catheter travels through a subcutaneous tunnel before entering a central vein. The tunnel and cuff help support longer-term access and securement.

A port is a totally implanted central venous access device. It is accessed through intact skin with a noncoring needle when therapy is needed.

Intraosseous access uses the medullary space when rapid vascular access is needed and conventional access is not available. It is a bridge until appropriate vascular access is established.

Subcutaneous infusion delivers selected medications or fluids into subcutaneous tissue. Assess the site for pain, leakage, swelling, and local reaction.

Securement limits catheter movement and accidental dislodgement. It can also reduce mechanical irritation at the insertion site.

Confirm the correct patient, solution or medication, concentration, programmed rate, line tracing, and alarm response. For high-alert infusions, follow the required independent-check process.

Use the filter specified by the medication, solution, manufacturer, or policy. A filter type is not universally interchangeable across infusates.

A CSTD is designed to limit the escape of hazardous drug vapor, aerosol, or liquid and to limit environmental contaminants entering the system. Use it as required by the hazardous-drug workflow.

Plan early around therapy needs, developmental considerations, vein preservation, and family involvement. Repeated failed attempts can quickly exhaust limited access options.

Protect upper-extremity veins that may be needed for future dialysis access. Coordinate device decisions with the patient’s renal and vascular-access plan.

Infiltration is leakage of a nonvesicant into tissue. Extravasation is leakage of a vesicant, which can cause tissue injury. Both require immediate assessment and action.

Stop the infusion immediately. Do not flush; keep the device in place initially for aspiration or antidote steps as directed by the drug-specific protocol, then escalate promptly.

Never force a flush against resistance. Stop, assess for mechanical causes and complications, and follow the approved occlusion-management protocol.

Monitor pain relief together with sedation level and respiratory status. Increasing sedation or respiratory depression requires immediate action under the organization’s protocol.

Only the patient should activate the demand button. Family- or staff-activated dosing can bypass the patient’s protective response to sedation.

Give through the prescribed route with a controlled delivery device and closely monitor hemodynamic response. Titrate only under the ordered parameters and facility protocol.

Use the required PPE, engineering controls, and disposal process. Exposure prevention protects the patient, staff, and environment.

Some antineoplastic agents can cause severe local tissue injury. Stop the infusion, avoid flushing, preserve the device for protocol-directed aspiration or antidote steps, and escalate immediately.

Recognize new symptoms promptly, stop or slow the infusion according to the ordered reaction protocol, assess airway and circulation, and notify the appropriate clinician.

Infusion reactions may emerge during administration. Baseline assessment, ordered vital-sign checks, and patient education about reportable symptoms support early recognition.

Verify the patient, drug, dose, allergies, compatibility, route, and prescribed infusion rate. These checks help prevent avoidable medication and reaction errors.

A reaction can be caused or worsened by a rapid infusion rate. Assess the patient, pause or adjust the infusion only as the protocol or order directs, and escalate symptoms promptly.

Use the required patient-identification and product-verification process at the bedside before starting the transfusion. Identification errors can be catastrophic.

Stop the blood product, maintain IV access with the compatible solution specified by policy, assess the patient, and notify the provider and blood bank immediately.

An isotonic solution has osmolality similar to plasma and primarily expands the extracellular fluid compartment. Choose fluids based on the clinical indication and order.

Watch for edema, weight gain, rising blood pressure, dyspnea, or crackles. Compare findings with the patient’s baseline and escalate clinically significant changes.

Never administer potassium chloride by IV push. Use the prescribed dilution, controlled rate, monitoring, and pump safeguards.

Do not assume two IV medications are compatible because both are commonly used. Check current compatibility information for the specific concentrations, diluents, and administration method.

PN can affect glucose, electrolytes, triglycerides, liver function, and fluid balance. Monitor the ordered laboratory values and clinical response.

Highly hyperosmolar PN formulations may require central venous administration to reduce the risk of peripheral vein injury. Match the formulation and route to the prescribed plan.

Abrupt interruption can create metabolic risk, especially with dextrose-containing PN. Follow the prescribed contingency plan and notify the appropriate clinician rather than improvising a substitute.

Stop or pause the infusion as the protocol directs, assess airway, breathing, circulation, and symptoms, maintain access as appropriate, and escalate without delay.