Flashcards in VIHA Package on IV Deck (33):
How often to flush IV?
What to do when discontinuing intermittent infusion (it has finished)
What is a continuous infusion?
Infusion of IV soln at constant rate
- May be primary infusion
What is the most common way to admin IV meds?
Secondary infusion (Piggyback)
What is an IV bolus vs an iV direct vs IV push?
Bolus = concentrated med or soln given over short period of time via infusion set of IV direct
* could be 1000mL!
IV direct = admin of med through syringe over specified period of time (GREATER than 1 MINUTE)
IV PUSH = rapid admin of bolus of med via syringe (in class said
Indication for IV push?
Used when need rapid response
Keep Vein Open
Refers to maintenance of vascular access device for fuure requirements of IV tx
- May include extension set with cap or continuous infusion with low rate
How do you know the rate for KVO?
Continuous infusions for KVO MUST contain a specific rate of infusion as ordered by the physician
What to do if you can't flush or aspirate the peripheral line?
What to check if you're able to flush the peripheral line with some resistance?
Assess IV tubing to see if kinked (either higher or at the insertion site)
Minimum size syringe for flushing CVC?
How often is CVC dressing changed initially after insertion?
How often then for transparent and gauze dressings and caps?
Initial dressing changed 24 hrs post insertion
- Transparent dressings and caps q 7days and PRN
- Gauze dressings and cap(s) q 2days and PRN
WHen does an xray need to be completed if you see a shift in the external segment of a CVC?
Adults movement > or equal to 5cm
Children > or equal to 1cm
Tubing change for CVC?
q96hrs if continuous infusion
q24hrs if intermittent use or TPN infusion
- What to do first?
- Aspirate to ensure patency
- Flush with 10mL NS pre and post meds
- Lock catheter with 3mls heparin lock solution q24hrs and after intermittent use
If you get to a patient and see that their PICC external segment has moved more than 5cm...can you proceed with care?
NO! Not until have had xray
When should measurement of the PICC line external segment occur?
on the first visit as well as prior to any episode of care (flushing, dressing change, etc.)
What's done at the PICC insertion site post insertion?
Moist warm compresses TID X20 min for 1st 3 days
Can person use arm after PICC insertion?
Yes, encourage regular use of arm
Is some bleeding normal after pICC insertion?
Yes, some expected for first 24-48hrs.
If dressing is leaking or site cannot be visualized, should do dressing change
WHen is tubing change done for PICC line?
I don't get this...see PICC care plan
When administering meds via intermittent infusion to gravity change needleless connector and extension tubing q 3-4days along with changes of the med admin set tubing
When administering meds via CADD pump, all tubings and needless connector should be changed Q 4 days
For maintenance line care such as weekly flushing and dressing changes, change the needleless connector and extension tubing Q 7 days during these visits or when:
- blood contamination
- removed for any reason
What to do before flushing PICC?
What to do if can't visualize numbers on PICc external segment to measure?
Can use dental floss and measuring tape
How often do you flush a PICC if it's not in use?
What does U.S.A.S. stand for as acronym for flushing a PICC line?
Access (blood return?)
How long to scrub PICC before flushing?
When checking for blood return, what to do if syringe becomes contaminated with blood? If doesn't?
If does - discard
If doesn't - can use this one + one more 10mL syringe (2nd and 3rd = 20mL total flush)
When do you check for blood return?
Prior to flushing and before admin of any med.
(does this mean twice if you're flushing before a med??)
Do you need to clamp the CVC following flushing?
If using extension tubing apply clamp when flush is finished. If not using extension tubing there is no need to camp (the Groshong valve prevents backflow)
When cleansing during dressing change over CVC, how long does it need to dry?
Allow 1 full minute per swab for drying - 3 full minutes total when using chlorhexidine swabs with alcohol
What to assess when doing dressing change over PICC?
- Change q7 days
- Check insertion site for redness, drainage, etc
- Measure external segment
- Palpate insertion site up to axilla to assess for induration, pain, or redness
Should you use the PICC line for high-pressure injections such as IV push meds?