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Module 2 > CVAD > Flashcards

CVAD Flashcards

1
Q

What is a CVAD?

A

Intravenous catheter or Infusion port

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2
Q

Lumens

A

Diameter of the tube

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3
Q

CVAD is designed to administer-

A

Meds, nutrients, IV fluids, and blood products through a central vein

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4
Q

Distal catheter

A

blood draw, blood infusions, meds, CVP

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5
Q

Proximal catheter

A

IV fluids, meds, blood draw

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6
Q

Medial catheter

A

TPN, meds, IV fluids

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7
Q

Catheters are inserted into __________ veins in central circulation with catheter tip ending in what?

A

Large
Ends in superior vena cava/ Rt atrium

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8
Q

CVAD requires _________ confirmation

A

X-RAY

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9
Q

CVAD is typically for ___________ to ___________ use

A

Moderate to long term

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10
Q

The proximal catheter is closest to the

A

Heart

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11
Q

Types of CVAD

A

Non-tunneled
Tunneled
Port-A-Cath

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12
Q

What should you tell the patient before CVAD insertion

A

Purpose
Estimated length of time they will have CVAD
What to expect (sterile procedure at bedside or IR)

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13
Q

Pt needs to be in trendelenburg position for CVAD insertion, why?

A

Enlarges vein, can help decrease chance of air embolism and allows easier access to the vein

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14
Q

Non-tunneled are most commonly inserted directly into what vein?

A

Subclavian

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15
Q

Non-tunneled CVAD are secured by what and where?

A

Sutures on outside the insertion site to the skin

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16
Q

Non-tunneled is for acute, moderate to long term, so about ___ weeks

A

6 weeks

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17
Q

Non-tunneled has a higher infection rate than tunneled, why?

A

Open to air, hanging out of skin

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18
Q

Picc

A

Peripherally inserted central catheter

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19
Q

Nurse can discontinue Non-tunneled, why?

A

Because it was not surgically implanted

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20
Q

Which veins are used for PICC, IF what can be accessed?

A

Basilic or cephalic vein, if peripheral vein can be accessed

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21
Q

Different types of tunneled CVAD

A

Broviac, Groshong, Hickman

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22
Q

Tunneled CVAD are surgically tunneled where?

A

Beneath skin

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23
Q

Tunneled CVAD are unique due to __________ _______ on the catheter

A

Dacron cuff

24
Q

Dacron cuff is sutured in place (SQ tissue) initially then

A

Scar tissue secures itself around the cuff

25
Q

Dacron cuff helps

A

Secure, prevent infection

26
Q

Common sites of tunneled CVAD

A

Subclavial vein, IJ, femoral vein

27
Q

Tunneled CVAD are chronic or

A

Long term (greater than 6 weeks)

28
Q

Why can nurse not discontinue tunneled CVAD?

A

Must be surgically removed because of Dacron cuff

29
Q

Implanted port is surgically implanted line

A

Underneath skin

30
Q

Implanted ports are tunneled through

A

Jugular, subclavian, or cephalic/basilic vein

31
Q

Implanted ports are long term, can be

A

Months to years

32
Q

Implanted ports can be ________ or ________ ports

A

Single or dual

33
Q

What are implanted ports for?

A

Chemotherapy

34
Q

What needle is needed to access implanted ports?

A

Huber needle

35
Q

Implanted ports are less

A

Restrictive

36
Q

Always access the CVAD site before

A

Any interventions
(Site/sutures/dessing/date. Lumens/clamps/caps. Fluids/meds)

37
Q

Always “_____________________” at least 15 seconds before accessing

A

Scrub the hub

38
Q

Always program CVAD infusions to

A

A pump

39
Q

Flush Lumens only using

A

10 mL flush syringes

40
Q

When do you flush Lumens

A

Every shift
After every medication
After every blood draw

41
Q

Dressing changes are 24 hours post

A

Insertion and q 7 days and PRN

42
Q

CLABSI

A

Most common complication of CVAD
Central line associated blood stream infection!!!

43
Q

Signs and symptoms of CLABSI

A

Redness
Drainage
Swelling
Discomfort at insertion site
Fever
Chills
Tachycardia
Increased WBC

44
Q

Nursing interventions to prevent complications of CVAD

A

Strict asepsis
NEVER touch with bare hands
Clean injection ports with alcohol swab before every access
Assessments and reporting concerns
Dressing changes
Pt/family teaching

45
Q

Pneumothorax

A

Air in the pleural space outside of the lung
“Collapsed lung”

46
Q

Signs and symptoms of pneumothorax

A

Dyspnea
Hypoxia
Tachycardia
Restlessness
Cyanosis
Chest pain
Decreased breath sounds
Obvious “chest deformity”

47
Q

Nursing interventions for pneumothorax

A

Monitor vital signs
Administer oxygen
Notify physician,CN, RRT
Prepare for chest tube, if indicated

48
Q

Venous air embolism

A

Air entering the circulatory system

49
Q

Signs and symptoms of venous air embolism

A

Acute dyspnea
Chest pain
Headache
Confusion
Hypotension
Hypoxia
Tachycardia

50
Q

Nursing interventions for venous air embolism

A

Keep Lumens clamped
Administer oxygen, monitor VS, pulse ox
Place pt on left lateral side in trendelenburg position
Stay with patient, notify physician

51
Q

Occlusion

A

Lack of blood return or sluggish flow

52
Q

Thrombosis

A

Clot that blocks the catheters lumen

53
Q

Catheter rupture

A

May be caused by excessive force used while flushing and wrong flush syringe

54
Q

Catheter migration

A

Displacement or lengthening of catheter

55
Q

Why do you need to place patient on left lateral side in Trendelenburg position for venous air embolism?

A

We want to trap the air embolism in the right atrium so that it doesn’t leave the heart and go to circulatory system and then to the brain

56
Q

If catheter does not have a blood return or will not flush, have patient try the following:

A

Deep breaths/cogh
Raise arms overhead
Sit/stand-up
Change positions in bed
Place in trendelenburg
Administer altepaste

Module 2 (15 decks)

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