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Year 2 PCM III > CV procedures > Flashcards

CV procedures Flashcards

1
Q

What are the indications to do a venipuncture

A

health screening, pre-operative evaluation and as a diagnostic aid

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2
Q

what are the relative contraindications with venipunctures

A

patient cannot sit still (child)
skin conditions interfering with access

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3
Q

what are the complications with venipunctures

A

bleeding (bruising, hematoma)
infection
arterial/nerve injury

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4
Q

what supplies do you need for venipuncture

A

tourniquet
gloves
alcohol swabs
appropriate needle device (vacutainer, butterfly, syringe)
blood specimen tubes
gauze pads or cotton

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5
Q

why do you usually use 21-22 gauge 1 “ needles for blood draws

A

smaller bores needles causes TBC hemolysis which may be mistaken for anemia or hyperkalemia

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6
Q

what is the most common method for venipuncture

A

vacutainer and needle holder

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7
Q

where do you put tourniquet

A

above antecubital fossa
snug slip knot

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8
Q

what vein is usualy most distended

A

median cubital

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9
Q

describe method to do venipuncture

A

nondominant hand to pull traction on skin below vessel to keen if from moving
dominant hand to insert needle at 15-30 degree angle until see flashback of blood
partially withdraw eedle if no flashback and reposition
**release tourniquet before removing needle
apply pressure after

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10
Q

what are the indications for intravenous catheterization

A

administration of fluids and medications

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11
Q

what are the relative contraindications for intravenous catheterization

A

patient inability to sit still

skin conditions interfereing with access

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12
Q

what are the complications with intravenous atheterization

A

bleeding (bruising/hematoma)

infiltration of fluid into subcut tissue

infection

thrombosis

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13
Q

What are the supplies for an IV catheterization

A

gloves- non sterile

alcohol or betadine

tourniquet

IV catheter

IV tubing

extension or saline lock

skin tape or OpSite

Gauze pads

IV solution

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14
Q

What must you do to the IV tubing before procedure

A

connect to solution bag and allow fluid to run thorugh tubing then clamp line closed

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15
Q

What veins to you usually select for IV catheter

A

basilic or cephalic on dorsal forearm

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16
Q

pros and cons of placing IV in metacarpal vein

A

easiest to visualize but mroe likley to occlude and prone to infiltration

17
Q

What type of sites do you avoid for IV catheter

A

areas of flexion and bony prominences

near multiple valves/branches

pre-exisiting catheter sites

anatomic deformities

ipsilateral masectomy or lymph node dissection

ipsi arteriovenous fistula or graft

18
Q

What type of local anesthetic can you use for IV catheterization

A

topical lidocaine based cream or ointment (30-60 minutes prior)

injectable lidocaine 1-2% injected 5-10 minutes prior to form a small wheel

19
Q

how do you place catheter

A

hold catheter between thumb and middle finger with index on top and at 30 degree angle

needle bevel dacing up and advance until feel a pop into vein and see flashback of blood

lower angle and advance 3-5 mm then slowly slide catheter sheath of needle into vein until only 1-3 mm of catheter remaining visible

withdraw needle completely and occlude blood with pressure then gauze under catheter hub, now can take off tourniquet

attach primed IV tubing and open clamp

20
Q

how do you known if the IV fluid may be flowing into surrounding tissue and not in vein

A

patient complains of pain or burning

skin appears to be swelling and not good flow from IV bag

21
Q

What are the indications for a central line

A

inability to maintain peripheral venous access

need for access to central circulation (pacemaker or pulmonary artery catheter)

infusion of hypertonic substancesor ones that can sclerose the peripheral veins(TPN or chemotherapeutic drugs)

hemodialysis

22
Q

what are the cotraindications for a central venous catheter

A

contralaterla pneumonectomy

bleeding diathesis

operator inexperience

infection at insertion site

recent placement of pacemaker

23
Q

what are the complications assoc with central venous catheter

A

arterial puncture

pneumothorax

thombosis

infection

cardiac dysrhythmia

24
Q

where can you insert a central venous line

A

subclavian catheter

internal jugular catheter

peripherally inserted central catheter

25
Q

What are the indications for an EKG

A

ches pain of suspected ardiac origin

suspected arrhythmia

screening for cardiac conditions (high risk)

pre-operative evaluation

26
Q

contraindications for EKG

A

patient inability to sit still

skin conditions

need for basic life support

27
Q

complications with EKG

A

skin reaction to adhesive

incorrect interpretation of results

28
Q

what can you find out on a EKG

A

arrhythmias

mI and infarction

pericarditis

chamber hypertrophy

electrolyte distuvances

drug toxicity

29
Q

which BB in heart has a anterior and posterior fasicle

A

the LBB

30
Q

What are the names of the leads in 12 lead EKG

A

3 standard limb leads

3 augmented limb leads

6 precordial leads

31
Q

where do you place the leads

A

Right arm (negatives)

Left arm lead one (horizontal) has positive

Left arm lead III has negative

Left Leg both +

32
Q

describe procedure for EKG placement

A

patient flat with arms at sides (if not flat obscures EKG so take note)

legs shoulder width apart

wipe areas with alcohol pad and shave any hair in way

R arm white

L arm black

left leg red

33
Q

describe placement of the 6 precordial leads

A

V1 (red) 4th intercostal space right sternal border

V2 (yelloq) 4th intercostal space at left sternal border

V4 (blue) 5th intercostal space L midclavicular line

V3 (green) halfway between 2 and 4

V5 (tan) L anterior axillary line same level V4

V6 (violet) midaxillary line same level as V4 and 5

Colors: rygbtv ryan yells good boy to violet

34
Q

which precordial lead is over tricuspid valve? mitral?

A

tircuspid is V2

mitral is V4

35
Q

rate of heart based on big boxes

300 150 100….

A

300 150 100 75 60 50 43 38

Year 2 PCM III (5 decks)

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