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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000437109.58306.a3
Feature Articles

CE Test 2.1 Hours: Intraosseous Vascular Access for Alert Patients

Contrada, Emily

Free Access
Continued Education
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* To take the test online, go to our secure Web site at .

* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.

* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is November 30, 2015.

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* We also offer CE accounts for hospitals and other health care facilities online at Call 1-800-787-8985 for details.

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These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.

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To provide information about the procedure and devices used for intraosseous vascular access.

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After reading this article and taking this test, you will be able to

* identify the indications for and advantages of using intraosseous vascular access.

* discern nursing considerations for pediatric and adult patients when using intraosseous vascular access.

1. The intraosseous (IO) space includes the spongy interior of a bone's epiphyses and the

a. articular cartilage.

b. epiphyseal plate.

c. cortex of compact bone.

d. medullary cavity of the diaphysis.

2. The IO space can absorb fluids and medications

a. because it contains many tiny blood vessels.

b. and transport them to the peripheral circulation.

c. for patients in resuscitative states.

d. despite any compromise of the bone.

3. Compared with peripheral veins, the IO space

a. absorbs medications slowly.

b. allows nontraumatic access.

c. is a less successful vascular access method.

d. does not collapse with dehydration.

4. Manual IO insertion devices use a removable trocar inside the needle to

a. guide insertion via fluoroscopy.

b. keep bone fragments from plugging the needle.

c. stabilize the needle during insertion through the bone.

d. remove a sample of marrow easily and safely.

5. Manually inserted needles are often used for which of the following patient populations?

a. adolescents

b. young and middle-aged adults

c. younger pediatric patients

d. older adults

6. An IO power driver

a. is appropriate for use with children and adults.

b. uses an up-and-down motion.

c. has a handle for pushing the needle inward.

d. uses a spring-loaded mechanism.

7. In pediatric patients, the preferred placement site is the

a. sternum.

b. distal femur.

c. distal radius.

d. medial proximal tibia.

8. In adult patients, which of the following placement sites has been associated with superior flow rates and better pain tolerance, making its use more common?

a. medial malleolus

b. proximal tibia

c. humeral head

d. distal tibia

9. A correctly placed IO catheter

a. allows gentle manipulation to improve flow.

b. sits firmly on the bone.

c. does not require an IV pump.

d. demonstrates brisk blood flow with aspiration.

10. A study using an IO power driver to achieve vascular access resulted in successful insertion and infusion in what percentage of the patients studied?

a. 61%

b. 75%

c. 83%

d. 94%

11. Of the following, extravasation of IO-infused fluids is most likely to result from

a. repeated IO attempts at the same site.

b. hypotonic fluid infusion.

c. high-volume fluid infusion.

d. administration of irritating medications.

12. Extravasation of IO-infused fluids can lead to the development of

a. fat embolism.

b. compartment syndrome.

c. hemarthrosis.

d. catheter dislodgment.

13. Study findings indicate that clinicians can prevent osteomyelitis by removing the IO needle within how many hours of insertion?

a. 24

b. 36

c. 48

d. 60

14. The pain associated with IO vascular access is typically a direct result of

a. site preparation.

b. needle insertion.

c. marrow aspiration.

d. fluid infusion.

15. Clinicians should weigh the potential benefits and risks of administering lidocaine intraosseously to pediatric patients with a history of

a. heart disease.

b. asthma.

c. nonfebrile seizures.

d. anemia.

16. According to the article, reasons for underutilization of IO access include the lack of all of the following except

a. awareness.

b. proper training.

c. proper equipment.

d. recommendations by specialty organizations.

© 2013 Lippincott Williams & Wilkins. All rights reserved.


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