VAD Flashcards
(21 cards)
What are CVAD used for?
Long term IV therapy, Chemo, FLuids, Nutrition, Blood products, and vesicants, Meds with pH < 5 or >9
What are the 4 types of CVAD?
Peripherally Inserted Central Catheter, Non-tunneled Central line,Tunneled Central line, Implanted ports
What is a Peripherally Inserted Central Catheter ?
AKA: PICC Line or PICC Cath, Single or multi-lumen, Inserted Peripherally (basilica or cephalic vein at AC) by a trained RN, Can be used for 7 days to several months, Need X-ray for confirmation of placement.
What are the uses for a PICC Line ?
IVF,Medications, Blood, Blood products, TPN, and Chemo
What are important nursing responsibilities for PICC line ?
Maintain the dressing, Keep it secured down, Keep site sterile Maintain the patency of the line( flush at intervals as ordered, assess for patency Q shift), Don’t advance if it migrates out
What is a Non-tunneled Multi-lumen Central Line ?
AKA: Triple lumen catheter, Uses 1-4 lumens( each has separate port with designated function), Used for 5-10 days, RN can take out
What are the placements for Non-tunneled multi-lumen central lines ?
Jugular, Groin, Subclavian
What is the distal lumen used for ?
16G, Blood Administration, CVP(Central venous pressure) readings
What is the medial lumen used for ?
18 G, TPN
What is the Proximal lumen used for ?
16 G, IVF, Blood draws, Med adminstration
What to do before insertion of Central Line ?
Informed consent, Assess for allergies
What to do during insertion of Central Line ?
Assist MD/APN, Sterile procedure/field ( usually a standardized kit), 10 degree Trendelenburg (if possible) on R side, Turn head, Valsalva maneuver (as appropriate)
What to do after insertion of Central Line ?
Confirm placement, Flush ;lumens only after placement is confirmed, Sterile dressing, Heparin Lock
What to do for Central Line Dressing ?
Sterile dressing change, change gauze Q 48 hrs/ PRN, change transparent Q 7 days/ PRN, Mask must be worn
What are some possible complications from a Central Line insertion ?
Infection, Hematoma/Bleeding, Pneumothorax/Hemothorax, Cardiac Dysrhythmias, Pericardial Tamponade, Air/Catheter Embolism, Pulmonary Embolism
What is a Tunneled Central Venous Catheter ?
Surgically Tunneled through the tissue in the chest, Terminates in the superior vena cava, Lasts months to years, Uses 1 or more lumens, Needs surgical removal
What is a Subcutaneous Implanted port ?
AKA: Port-a - Cath, INfuse- a- catch, Mediport, Surgically inserted into Subcutaneous pocket, uses a single or dual port, Used for long term and complex IV therapy, Dual is used for Dialysis, Flush Q 28 days, Heparinize Q 4 weeks, Lasts 2- 3 years
What is a Pheresis/ Dialysis Catheter ?
AKA: Quinton Cath or Permcath or Vascath, Uses two lumens (Blue=venous, Red=Arterial), Inserted at bedside or surgically, Only to be used for Dialysis unless emergency situation, Heparin Lock,
What to remember about using Central Lines ?
Do not use scissors around CVAD, Always use 10 ml syringes for obtaining sample or flushing, prepare syringes/ supplies in advance, Never forcibly flush a CVAD, Keep Central Lines patent, When drawing blood aspirate and discard 3- 5 ml prior to obtaining sample unless you are drawing a blood culture, For blood culture, change cap, then use first drawn blood for the culture, Always flush with saline before and after giving medications, Aspirate 3- 5 ml, Flush 5-10 ml, Give medications, Flush 5-10 ml, Heparin Lock
How to prevent Central line infection ?
Hand hygiene, Sterile technique dealing with line, Scrub with chlorhexadine/Alcohol when accessing, Avoid using femoral veins fro Central lines, Notify MD immediately if site looks infected, Remove Central line when no longer needed
Central line Care
Change transparent dressing Q 7 days, Gauze dressing Q 24 hrs, Tubing Q 96 hrs, Caps Q 7 days, cleanse caps prior to Tubing change, IVP medications or flushing with alcohol swab
