Module 1: Part 1 - PICC Flashcards
(39 cards)
Who is legally allowed to place a VAD?
Physicians or specially trained nurses.
How does a CVAD differ from a short-peripheral or midline catheter?
The furthest tip of the catheter in a CVAD ends in a larger BV.
Where should the tip of a CVAD placed in the upper body end?
In the lower segment of the inferior or superior vena cava at, or near, the cavoatrial junction.
Where should the tip of a CVAD placed in the lower body end?
In the inferior vena cava above the level of the diaphragm.
In adults, where should the tip of a CVAD placed in the femoral region end?
Nowhere, this is not recommended for adults.
What factors should be considered when determining placement of a CVAD?
(7, know at least 4)
- Type and duration of infusion therapy
- Vascular characteristics
- Age
- Co-morbidities
- Hx of infusion therapy
- Preference for location
- Osmolarity and pH of the solution to be administered
What material is a CVAD composed of?
Silicone or polyurethane.
CVADs may be coated in what kinds of solutions? (4)
- Silver
- Antibiotics
- Minocycline/rifampin
- Chlorhexidine
(Fuck those last 2…they’ll be wayyy too hard to remember…)
What are 2 possible catheter tip configurations?
- Open-ended
2. Valve ended
How would you describe and open-ended catheter tip?
Similar to the tip of a straw.
How would you explain a valve ended catheter tip?
A rounded tip with a 3-way-pressure-activated valve.
What are some benefits of a valve ended catheter?
Prevents reflux of blood into the catheter to reduce the risk of hemorrhage, air embolism, and occlusion.
Is heparin needed to maintain patency in a CVAD?
No, but it still needs to be flushed with NS.
Do CVADs have single or multiple lumens?
Either!
Why might pt have a device with multiple lumens?
If they require numerous infusions and blood samplings, or if their medications are incompatible, but still need to be administered simultaneously.
Explain what an implanted venous port is.
A CVAD that has a reservoir placed in a “pocket” under the skin with the catheter inserted into a major vessel.
Where is the hub for an implanted port?
There is no hub, access to an implanted port is gained only by inserting a special 90 degree angle, noncoring needle through the skin and into the self-sealing injection port in the septum of the reservoir.
How often does an implanted port need to be flushed?
Monthly with a heparin solution or NS.
Key components of the IHI Central Line Bundle: (5)
- HH before and after catheter insertion
- Maximal sterile barrier precautions with insertion
- Chlorhexidine gluconate (CHG) skin antisepsis
- Optimal catheter site selection
- Necessity of daily review of the condition of the line
What sterile barrier supplies should the physician or nurse inserting the catheter be wearing?
- Head covering
- Gown
- Mask
- Sterile gloves (powder free)
Prior to insertion, assess the pt’s _______ status and what does this include?
Hydration status, this includes assessing the skin turgor, dryness of the mouth, skin texture, and fluid intake/output.
Before drawing blood, how long should all infusion be stopped (unless unable to stop)?
1-5 minutes.
If you are unable to stop infusions before drawing blood, what should you do instead?
Draw the sample from a peripheral vein.
When drawing up a sample from a multilumen catheter, does it matter which lumen you draw from?
Yes, you should draw it from the distal lumen (unless specified otherwise by the manufacturer).
