Central Venous Access Device (CVAD) Flashcards
1
Q
Uses
A
- blood
- antibiotics
- meds/solutions with limited peripheral access
- TPN
- chemotherapy ongoing or at home
- hemodynamic monitoring
2
Q
Non tunneled catheter
A
- used <2 weeks (short term)
- insert directly into central vein
- all types of IV therapy
- fast access: may be placed @ bedside or emergency
- highest risk for infection**
3
Q
Tunneled catheter
A
- frequent, long term
- tunnel through percutaneous tissue
- provide more reliable IV access
- use for extended antibiotics, chemo, PN
- surgically inserted (synthetic cuff to anchor, no dressing after healing)
- lower chance of infection
4
Q
Implanted ports
A
- long term, > 1 year
- surgically implanted into chest wall
- injection port and catheter
- blood draws may be done
- little maintenance when not in use
- accessed with non-coring needle
5
Q
SASH
A
Saline flush
Admin
Saline flush
Heparin
6
Q
Peripherally inserted central catheter
A
- intermediate term < 6 month
- used for most IV therapies and obtain blood drawn
- surgically or non surgical
- Sterile technique**
- risk for infection
- No BP or venipuncture in arm with PICC**
7
Q
Advantages
A
- reduce peripheral venipuncture
- reduce trauma/anxiety r/t vp and med admin
- long term venous access
- safer route of admin for vesicant therapy
8
Q
Disadvantages
A
- increased risk of infection
- routine care/maintenance
- placement risk for bleed, venous obstruction, pneumothorax**
- placement conform via X-RAY after insert and before use
9
Q
Catheter flushing
A
- aspirate blood return to check for placement
- flush with 10mL NS per policy in use or not (blood return)
- before or after med admin
- use turbulent motion (pulsating, flush then stop)
- with heparin per policy
10
Q
Blood sampling
A
- stop infuse at least 1 min
- flush NS
- withdraw 10mL blood, DISCARD
- new 10mL syringe withdraw amount for test
- flush NS
- flush heparin
11
Q
Key points for blood sampling
A
- clamp engaged when disconnecting
- blood cultures not recommended unless source of infection
- no venipuncture on arm with PICC
- always use pulsating technique
12
Q
Med admin (IV) steps
A
- flush NS
- aspirate for blood
- flush NS
- med
- flush NS
13
Q
Key points for med admin
A
- safety clamp engaged when disconnect
- dilute IVP med over 3-5 min
- always use pulsating technique
14
Q
Remove nontunnel
A
- supine or trendelenburg with site at or below heart
- remove old dressing while stabilizing hub of cath
- pt hold breath and perform Valda a maneuver
- remove slowly
- apply pressure with sterile dress until hemostasis
- apply ointment and sterile dressing
- measure and compare, ensure cath tip in tact
- document: procedure, length, site access, pt tolerant
- **if resist STOP. Wait and try again. Never force. Still resist replace sterile dressing and call PCP
15
Q
Dressing change non tunnel
A
- nurse and pt wear mask
- remove old while stabilizing cath hub
- sterile gloves
- aseptic cleaning solution
- measure length
- apply chlorapep to protect tissue
- apply occlusive dressing
- document same as insertion
