Exam 1: IV infusion

Question 1

What is the purpose of a VAD

Answer 1

to provide access route for the administration of parenteral fluids and meds

Question 2

PIV include

Answer 2

short peripheral venous cath
midline cath

Question 3

Central line include

Answer 3

PICC
CVC
Implant ports
Hemodialysis cath

Question 4

PIV advantages vs disadvantages

Answer 4

Advantages: easily inserted, low cost, minimal complications, use: short term

Disadvantages: use is limited to fluid/meds, Local tissue injury (infiltration), easily clotted

Question 5

What catheter gauge is adequate for most therapies including blood

Answer 5

22 gauge

Question 6

What catheter gauge is indicated for small children and infants

Answer 6

24-26 gauge

Question 7

What is the preferred side of catheter gauge for surgery

Answer 7

18 gauge

Question 8

When we assess an IV site what do we look for

Answer 8

redness, swelling, tenderness, blood return, secure site

Question 9

What is the time for replacement of a PIV

Answer 9

72 to 96 hours

Question 10

What is the time for replacement of tubing for a PIV

Answer 10

72-96 hours

Question 11

________ leakage of fluid out of vessel into tissue (not irritating fluid –> no necrosis)

Answer 11

infiltration

Question 12

__________ leakage of fluid that will cause tissue injury (necrosis –> sloughing)

Answer 12

extravasation

Question 13

_______ warm, tender, vessel of hart (CORT)

Answer 13

phlebitis

Question 14

Where does a midline catheter terminate

Answer 14

Peripherally inserted catheter with the tip terminating in proximal portion of upper
extremity at or below the level of the axilla

Question 15

Generally how long at midlines

Answer 15

3 to 8 inches (double or single lumen)

Question 16

What vein is usually used for midline insertion

Answer 16

antecubital vein

Question 17

What are midlines used for

Answer 17

fluid or drug therapy lasting longer than 6 days and up to 14 days

Question 18

Where does a PICC tip terminate?

Answer 18

tip termination in the superior vena cava near the junction with the right atrium

Question 19

Is a PICC long term

Answer 19

yes

Question 20

What is required with PICC placement that isn’t for other access

Answer 20

X ray verification

Question 21

T/F avoid the use of stop cocks to minimize infection

Answer 21

True

Question 22

What is the purpose of dressings with VAD

Answer 22

Dressing function to secure the catheter and protect from site contamination

Question 23

What must we do to maintain dressing integrity

Answer 23

keep dressing clean and dry

Question 24

Dressing changes: transparent semi-permeable membrane type must be changed __________ but the tape and gauze dressings need to be changed ______

Answer 24

weekly; every 48 hours

Question 25

CVC-non tunneled: most common vessels

Answer 25

subclavian vein internal jugular vein femoral vein

Question 26

The patient is placed in supine position, site is cleansed (chlorhexidine), skin is anesthetized, a large bore needle is inserted beneath the clavicle. The catheter is advanced over a guidewire. The catheter is sutured–a sterile transparent dressing is applied. What type of CVC is this?

Answer 26

a non tunneled CVC

Question 27

With a CVC do you need x ray placement confirmation?

Answer 27

yes X-ray to confirm placement: location in superior vena cava and rule out pneumothorax (air in cavity) Run isotonic solution at KVO until placement is confirmed

Question 28

Distal lumen is used to infuse

Answer 28

blood or fluids

Question 29

Middle lumen is used for

Answer 29

PN

Question 30

proximal lumen is used for

Answer 30

fluid or infused meds

Question 31

Which CVC is used for long term use

Answer 31

tunneled

Question 32

Cuffed catheters inserted surgically, threaded under the skin Tip of catheter lies in the SVC What type of CVC is this

Answer 32

tunneled

Question 33

Which CVC has decreased infection risk

Answer 33

tunneled

Question 34

Implanted port is used for very long term use--home therapy (over _______)

Answer 34

1 year or longer

Question 35

with a port what is the placement

Answer 35

Subcutaneous port placed under subcutaneous pocket, requires accessing–huber needle

Question 36

interventions for reduction in infection risk with IV

Answer 36

Clean needleless system connections before use with antimicrobial for 30 seconds Do not tape connections between tubing sets Use evidence based hand hygiene guidelines from CDC and OSHA