14 CVADS Flashcards
What is needed to maintain patency in a groshong?
NS only
What is a groshong cath?
clised tip with slit antireflux valves along the sides to prevent blood from backflowing. can be single, double or triple lumen
What is a TIVAD
another word for implanted ports. ‘totally implanted venous access devise’ vs ‘partially implanted’ or PIVAD like hickman
Where is a PICC inserted? where does it go?
In a periph vein (cephalic or basilic) and advanced in to the SVC.
Should PICCs have sutures?
preferably not, infection risk
What should be considered when choosing the right CVAD?
age, lifestyle, pt size. for example, most leuk patients get ports, but a very obese teen coming up on steroid therapy may not be a good candidate. or a pt who loves sports should get a port not a hickman, etc.
Why avoid groin lines?
risk of infection/clot
Who’s more likely to get CVAD infection, leuk or solid tumors?
leuks.
What does nutrition have to do with CLABSI?
poor nutritional status, including use of TPN and lipids, are assoc with high risk of CLABSI
What are the 4 key nursing aspects of CVAD management?
on (1) prevention of infection, (2) maintaining patency, (3) maintaining placement (including infiltration and migraton), and (4) patient and family education and staff education and training.
What to do if an unaccessed port appears infected?
Do not access, peripheral cultures, and antibiotics until swelling goes down, then try to access port an send culture/start abx
How often to replace gauze dressings on short term cvads?
every 2 days
How often to replace transparent dressings on short term cvads?
every 7 days
How to clear ‘lipid emulsion residue’ that is occluding a CVAD?
70% ethanol or NaOH per policy
Why may shoulder movement pinch the catheter?
It may be inserted into the subclavian which passes between the clavicle and first rib. This is why raiding arms may help.
When to use dezroxane for extravasation?
Dauno/doxo, Idarubicin,
When to use hot vs cold after extravasation?
Warm-etoposide, oxaliplatin and vinblastine/Vcr
Cold-everything else
When vcr/vbl/vinorelbine infiltrayes what to do
Warm pack and hyaluronidase
What to remember about cold packs and dezroxane
Dezroxane is vesicant antidote- withold cold pack for 15 min before and after dezroxane infusion
