VAD Flashcards
(33 cards)
What is the primary purpose of Central Venous Access Devices (CVAD)?
Long term IV therapy for chemo, fluids, nutrition, & blood products
Where does the lumen of a Central Venous Access Device terminate?
In the chest - vena cava (SVC or IVC) or right atrium
What is a key benefit of using Central Venous Access Devices?
Decreased vessel irritation, inflammation, & sclerosis
What type of imaging is used to confirm the placement of a Central Venous Access Device?
X-ray
Name the four types of Central Venous Access Devices.
- Peripherally inserted central catheter (PICC)
- Non-tunneled central line
- Tunneled central line
- Implanted ports
What is a PICC line?
A Peripherally Inserted Central Catheter
What can a PICC be used for?
IVF, medications, blood and blood products, TPN, chemo
Incompatible meds can flow through the same PICC through different hubs
Who is allowed to insert a PICC line?
- Inserted peripherally in the basilic or cephalic vein
- Only a trained RN
Goes through arm and ends up above the R atrium
What should a patient do when a PICC line is being removed?
Take a deep breath and hold it
What is the maximum duration a PICC line can be used?
7 days to several months
What is the purpose of flushing a PICC line?
To maintain patency
What should not be done in the arm with a PICC line?
No BP or sticks
What are the responsibilities of an RN regarding a PICC line?
- Maintain the dressing
- Keep it secured and sterile
- Maintain patency of the line
If PICC moves or becomes disloadge, the RN can cannot push the line forward, but can remove it
What is the typical use duration for a non-tunneled multi-lumen central line?
7-10 days
Non-tunneled multi-lumen catheter placement
Jugular, femoral, or groin through skin and into the vessel
Has 1-4 lumens
What are the functions of the three lumens in a triple lumen catheter?
- Distal: 16g for blood admin, CVP readings
- Medial: 18g for TPN
- Proximal: 16g for IVF, blood draw, meds
Proximal is closest to the patient
What is required before inserting a central line?
Informed consent and assessment for allergies
What position should a patient be in during central line insertion?
10 degree Trendelenburg (if possible), R side
What is the purpose of a sterile dressing change for a central line?
To prevent infection
What are some complications associated with central lines?
- Infection
- Hematoma/bleeding
- Pneumothorax/hemothorax
- Pericardial tamponade: sacks of blood pushing on heart
- Air/catheter embolism
- Pulmonary embolism
Heparin lock the central line
What is unique about tunneled central venous catheters?
They are surgically tunneled through subcutaneous tissue in the chest
skin acts a protective barrier
terminates in SVC
What is the lifespan of tunneled central venous catheters?
Months to years
What is the purpose of the dacron cuff on tunneled central venous catheters?
It acts as an antimicrobial barrier and stabilizes the catheter
