A nurse is preparing to start an IV in a patient's non-dominant extremity but notes that this arm is edematous. Which of the following are appropriate actions for the nurse to take? Select all that apply.

 

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Correct

- Select a distal site in the edematous extremity for cannulation

- Select any site on the non-edematous extremity for cannulation

- Use a transilluminator on the skin to find a proximal vein on the edematous extremity

- Select a distal site on the non-edematous extremity for cannulation

- Contact the provider to clarify that an IV is necessary

Rationale

-"Select any site on the non-edematous extremity for cannulation" and "Select a distal site on the non-edematous extremity for cannulation" are correct. When starting an IV in a patient, using an edematous extremity is contraindicated. While it is good practice to cannulate in a non-dominant arm for the patient's convenience, it is more important to avoid an area of the body with an abnormal presentation.

-"Select a distal site in the edematous extremity for cannulation" and "Use a transilluminator on the skin to find a proximal vein on the edematous extremity" are incorrect. The nurse should avoid this side completely when selecting an IV site.

-"Contact the provider to clarify that an IV is necessary " is incorrect because this issue can be resolved by the nurse's good clinical judgement. It does not need to be escalated to the provider.

References:
Silvestri, L. A. (2017). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier

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Question ID - 16100

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