Central Venous access devices (Complete) Flashcards

(29 cards)

1
Q

What are CVADs?

A

Catheters placed in large blood vessels such as the subclavian vein and jugular vein

CVADs stand for Central Venous Access Devices.

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2
Q

What are the three main types of CVADs?

A
  • Centrally inserted catheters
  • Peripherally inserted central catheters
  • Implanted ports
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3
Q

What is the primary purpose of CVADs?

A

Permit frequent, continuous, rapid, or intermittent administration of fluids and medications

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4
Q

What types of drugs can be administered through CVADs?

A

Drugs that are potentially vesicants, blood/blood products, and parenteral nutrition

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5
Q

Who are CVADs particularly useful for/ Common indications

A

Patients with limited peripheral vascular access or need for long-term vascular access
-Hemodynamic monitoring
-Venous blood samples
-Injection of radiopaque contrast media

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6
Q

What are two advantages of using CVADs?

A
  • Immediate access
  • Reduced venipunctures
  • Decreased risk of extravasation
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7
Q

What are two disadvantages of using CVADs?

A
  • Increased risk of systemic infection
  • Invasive procedure
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8
Q

Describe a centrally inserted catheter.

A

-Inserted into a vein in the chest or abdominal wall with tip resting in distal end of superior vena cava
-Nontunneled or tunneled

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9
Q

What is the purpose of the Dacron cuff in a tunneled catheter?

A

Anchors catheter and decreases incidence of infection

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10
Q

What are examples of long-term tunneled catheters?

A
  • Hickman
  • Broviac
  • Groshong

(can be single, double, or triple lumen)

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11
Q

What does a PICC stand for?

A

Peripherally inserted central catheter
-Single or multi-lumen, nontunneled

Pink bracelette

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12
Q

What is the duration of use for a PICC?

A

For patients who need vascular access for 1 week to 6 months
*Cannot use arm for BP or blood draw

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13
Q

What are two advantages of using a PICC?

A
  • Lower infection rate
  • Fewer insertion-related complications
  • Decreased cost
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14
Q

What are two complications associated with PICCs?

A
  • Deep vein thrombosis
  • Phlebitis
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15
Q

What is an implanted infusion port?

A

Central venous catheter connected to an implanted, single or double subcutaneous injection port

Drugs are injected through skin into port

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16
Q

What materials can the port of an implanted infusion port be made from?

A
  • Titanium
  • Plastic

With self-sealing silicone septum

17
Q

What is a key advantage of implanted infusion ports?

A

-Good for long-term therapy
-low risk of infection
-Cosmetic discretion

18
Q

What are midline catheters?

A

Peripheral catheters 3 to 8 inches long, single- or double-lumen

(Use and care similar to PICC)

19
Q

How long may midline catheters stay in place?

A

Up to 4 weeks

20
Q

What is a potential complication of CVADs related to catheter occlusion?

A

-Clamped or kinked catheter,
-tip against wall of vessel, -thrombosis,
-precipitate buildup in lumen

21
Q

What can cause an embolism in relation to CVADs?

A

-Catheter breaking,
-dislodgement of thrombus,
-entry of air into circulation

22
Q

What can lead to infection in CVADs?

A

Contamination during insertion or use, migration of organisms along catheter, immunosuppressed patient

SCRUB THE HUB

23
Q

What is a serious complication related to CVAD

A

Pneumothorax
-Perforation of visceral pleura, Catheter migration due to
-improper suturing,
-trauma, forceful flushing,
- are spontaneous

24
Q

What is important for maintaining patency of a PICC?

A

Flushing is important with normal saline prefilled syringe using only a 10 mL syringe or larger

Flush before and after

25
What is the preferred cleansing agent for changing CVAD dressings?
Chlorhexidine
26
What should be done when removing a CVAD?
Gently withdraw while patient performs the Valsalva maneuver and apply pressure with sterile gauze -Apply antiseptic ointment and sterile dressing
27
What must be ensured when removing a CVAD?
That the catheter tip is intact
28
Nursing Management (general)
-Inspect catheter and insertion site -Assess for pain -Change dressing and clean according to institution policies -Clorhexidine and transparent semipremeable dressing or gauze dressing
29
Nursing management (cleaning)
Change injection caps -Have patient turn head to opposite side -Valsalva if no clamp Flushing is important -Normal saline prefilled syringe -Use only 10 mL syringe or larger -Push-pause technique