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CVAD Flashcards

(63 cards)

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1
Q

CVAD stands for

A

Central Venous Access Device

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2
Q

With a CVAD you can administer what types of fluids/products

A

IV fluids, blood products and medications

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3
Q

The tip of the CVAD sits in the ________ or ________

A

Superior or Inferior Vena Cava

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4
Q

What 3 veins can the CVAD be inserted

A

internal jugular (IJ), subclavian vein, femoral vein or brachial vein. If femoral = more chance of infection

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5
Q

Another way CVAD can be placed

A

under the skin (aka port)

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6
Q

After placing CVAD - first thing you should verify_______ via_________

A

location of the tip via a chest xray (magnet)

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7
Q

One exception to verifying placement

A

if placed under fluoroscopy

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8
Q

What is Fluoroscopy?

A

imaging technique that uses X-rays to obtain real-time moving images of the interior of an object.

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9
Q

How long can CVADS remain in place (depending on the type)

A

several weeks to months

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10
Q

Who can benefit

A

those requiring long term IV treatments

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11
Q

What should you avoid giving in CVAD_______ or flushing with smaller syringe (< 10 ml) due to ____________

A

medications
may result in too much pressure = rupture of catheter

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12
Q

Some reasons to use CVAD

A

parenteral nutrition
chemo/other irritating (vesicant) solutions
Blood products
antibiotics
when peripheral access is limited
CVP (central Venous pressure) monitoring = fluid overload
Hemodialysis

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13
Q

What is the lumen of a catheter

A

hollow channel within a tube

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14
Q

Can you have more than one lumen?

A

Yes, single, multiple - up to 5

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15
Q

If you have single lumen and giving parenteral nutrition - what can’t you do?

A

use to sample or transfuse blood - as blood tends to stick to tubing - makes nutrition hard to flow

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16
Q

Names of ports of the lumen

A

proximal, medial distal

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17
Q

Type of catheters

A

Short
midline
PICC - Peripheral inserted central catheter
Non-tunneled percutaneous catheter (CVC)
Tunneled catheters
implanted ports
hemedialysis catheters

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18
Q

Short - how long?

A

3/4 - 1 1/4 inch

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19
Q

Short gauge?

A

26 (smallest) - 14 (largest)

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20
Q

Short timeframe in and when to assess

A

no specific (policy) and Q 4 hours minimum

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21
Q

Midline - how long

A

3-8 inches, 3-5 French and can be double or single

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22
Q

Midline - where placed

A

upper arm

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23
Q

midline used for

A

hydration and drug therapy

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24
Q

Midline time in

A

used when needed for up to 6 days and UP TO 14 DAYS!!!

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25
Midline - do not use to
vesicant drugs, parenteral nutrition, draw blood
26
PICC means
Peripherally Inserted Central Catheter - LONG
27
PICC is inserted
into basilic (preferred) or cephalic vein in arm
28
PICC line ends
in the superior vena cava just above the right atrium - BAD IF IN ATRIUM - higher risk of thrombosis
29
PICC - single or multiple lumens? Color is
yes, can be both purple
30
Gold standard placement verification for a PICC
3CG technology - magnetic tracking - CAN ONLY USE IF PT IS IN NORMAL SINUS RHYTHM
31
Don't use 3CG technology (magnet tracing) for PICC placement if
pt is not in NSR - normal sinus rhythm
32
PICC indicated for
IV fluids, medications, blood and blood sampling - great for home IV treatments
33
In arm with PICC - DO NOT
take BP, draw blood or any injections
34
Greatest risk to pt with PICC
DVT and infection
35
Non tunneled Central Venous Catheter - what makes it non tunneled?
It goes directly to vein and is not put under skin prior to the insertion point
36
Where are Non tunneled Central Venous Catheters placed
subclavian in upper chest or jugular vein into Superior Vena Cava or less often femoral then Inferior Vena Cava
37
Non tunneled duration\_\_\_\_\_\_\_ due to \_\_\_\_\_
short term due to high rate of infection (2 weeks) (access is direct to vein = bacteria)
38
Tunneled central venous catheters - what makes them tunneled?
portion lies in a subq tunnel on skin
39
What does tunneled have which helps reduce infection?
cuff with antibiotic at skin insertion
40
when is tunneled used
frequent long term infusion
41
why not just use a PICC instead of tunneled?
if someone uses there arms a lot - paraplegic
42
What is a portacath?
device implanted under the skin - appears as a bump
43
Implanted ports are most often used for\_\_\_\_\_\_\_\_\_ because of compromised immune system
chemo
44
Is any of the catheter outside of body with portacath?
no - all under skin - port is self sealing
45
How is portacath accessed?
Huber needle - a non coring/non barred needle - it is curved so it does not go through port
46
How many times can you access portacath with same needle?
about 7 days
47
Portacath - after accessing and prior to each use:
aspirate for blood return flush with 10 ml NS
48
Portacath - prior to deacessing, removing the needle
lock with heparin solution (per policy) flush with NS
49
Largest catheters
hemodialysis
50
common complication for hemodialysis catheter
CLABSI = central line associated blood stream infection AND vein thrombosis
51
Who can access
only trained Hemodialysis nurses
52
Change hemodialysis dressing
Q 48 hours/with treatment/when soiled
53
Most common infection with CVADS
staph aureus, yea and fungi
54
what to monitor for infection
fever, redness, swelling, drainage, pain, chills
55
How to prevent infections
proper technique - be sure draping and gloves are sterile, wear gown and mask - everyone in room hand hygiene prepare insertion site with chlorhexidine and alcohol Scrub the hub with alcohol at least 15 sec dressing changes access necessity daily (do they need it) watch for early signs of infection
56
Possible complication with CVADS
air embolus with discontinuation or when opened
57
CVAD dressing changes mandate the use of
sterile technique
58
Change CVAD dressings Q
7 days/hospital policy
59
What to ask patient with catheters
allergies to chlorohexidine gluconate and latex
60
New insertion of CVAD requires all new
tubing and fluids
61
After completion and prior to shift
LABEL tubing, dressing and IVF and check them at start of shift!!
62
What do to if no label?
change
63
Cath often used with long term hemodyalisis patients
tunneled - fistula healing can take up to 6 mo

Med surg 2 (12 decks)

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