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Med Surg I > Wk 2 Central Venous Catheters > Flashcards

Wk 2 Central Venous Catheters Flashcards

(74 cards)

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1
Q

4 reasons someone might have a CVC

A

TPN
Chemotherapy
Long-term antibiotic use
Loss of peripheral access

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2
Q

TPN is very __tonic

A

hypertonic, high in glucose, dextrose

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3
Q

The peripheral vein can’t handle

A

TPN because it is so hypertonic

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4
Q

Chemotherapy agents are __

A

vesicants

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5
Q

What are vesicants?

A

A blister agent, or vesicant, is a chemical compound that causes severe skin, eye and mucosal pain and irritation.

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6
Q

Deep central lines are __ __

A

Non-tunneled CVC

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7
Q

Where are deep CVCs (non-tunneled CVC) put in?

A

Subclavian vein
Internal jugular

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8
Q

Tunneled CVCs are put in by…

A

the surgeon in the OR and they are tunneled in subcutaneous tissue for the purpose of staying put

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9
Q

Deep lines, or non-tunneled CVCs are basically like an…

A

IV stick in the large vein

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10
Q

What are three examples of tunneled CVCs?

A

Hickman
Groshong
Broviac

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11
Q

Tunneled CVCs are frequently seen in __ patients

A

cancer

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12
Q

Implantable ports are also called…

A

portacaths or power port

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13
Q

What are implantable ports?

A

Implanted venous access devices that don’t have external tubing involved

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14
Q

What are the four types of CVCs

A

Non-tunneled CVC
Tunneled CVC
Implantable ports
PICCs

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15
Q

Where does the tip of a PICC stay?

A

superior vena cava or right atrium

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16
Q

PICCs are most commonly inserted in the…

A

ante cubical site

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17
Q

With a triple lumen deep line (TLDL), the medications and IV solutions come out at…

A

different places along the port, so you can hang things that are incompatible with each other

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18
Q

Where is the insertion site for a subclavian CVC?

A

Apex of the lung

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19
Q

If the provider perforated the pleura or apex while inserting a subclavian CVC, what might happen?

A

Pneumothorax

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20
Q

How many ports can a non-tunneled CVC have?

A

Up to 5

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21
Q

Who can put in a non-tunneled CVC?

A

MD or NP

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22
Q

How long is a non-tunneled CVC?

A

Typically 7-10 inches long

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23
Q

Where most often, does the tip reside for a non-tunneled CVC?

A

In the superior vena cava

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24
Q

What is most always done after a non-tunneled CVC is placed?

A

A chest x-ray because of the risk for a pneumothorax

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25
A non-tunneled CVC is typically recommended for...
Short term, emergency, critical care, surgery
26
What is a non-tunneled CVC typically not recommended for?
Home/ambulatory clinic care
27
What are 4 complications of a non-tunneled CVC?
Bleeding at the site Air embolism Pneumothorax CLABSI
28
CLABSI are the number 3 reason for
hospital acquired infections
29
Who removes non-tunneled CVCs?
Typically the RN
30
What should the nurse check before removing a non-tunneled CVC?
INR status to see if patient has clotting issues
31
Why should a nurse use a measuring tape when removed a non-tunneled CVC?
To measure it and make sure that as much came out as went in
32
What position will the patient be in when a nurse is discontinuing a non-tunneled CVC?
Supine or trendelenburg
33
What will the nurse ask the patient to do when removed a non-tunneled CVC?
The Valsalva
34
What is the valsalva maneuver?
Asking the patient to exhale through their mouth or hum
35
What is the benefit of the valsalva maneuver?
Prevents atmospheric air from being sucked in to the big vessel when the catheter is pulled
36
After the nurse removed the non-tunneled CVC, what should they do?
Hold pressure for 3-5 minutes, and apply an occlusive dressing
37
What 4 supplies should the nurse have when removing a non-tunneled CVC?
Sterile suture removal kit Sterile AND clean gloves Occlusive dressing Measuring tape
38
Sometimes a provider may put in an order for the culture of the...
CVC tip after it has been removed
39
What type of CVC is this?
Subclavian non-tunneled CVC
40
What type of CVC is this?
Internal jugular non-tunned CVC
41
What type of CVC is this?
Tunneled CVC
42
What is the advantage of a tunneled CVC?
Stability, less likely that it will be pulled out
43
Where are tunneled CVCs placed?
In the OR
44
Three types of tunneled CVCs
Broviac Hickman Groshong
45
When are tunneled CVCs used?
When treatment is frequent and prolonged (even years)
46
What is the advantage of a tunneled CVC in comparison to an implanted port?
Doesn't require needle sticks (implanted ports do)
47
What is the disadvantage of a tunneled CVC in comparison to an implanted port?
With a tunneled CVC, there is a prolonged break in skin integrity
48
Irrigation and site care of tunneled CVCs should be...
Followed per agency policy
49
What are 4 complications of tunneled CVCs?
Catheter damage Occlusion Thrombosis Sepsis
50
Who will remove a tunneled CVC?
The provider
51
What type of CVC is this?
Implanted Port (Portacath/PowerPort)
52
What does the nurse use when it is time to give medication via a portacath?
Huber needle through a round device underneath the skin
53
Who gets an implanted port?
Patients who require IV therapy up to a year or more
54
Where is an implanted port placed?
In the OR, catheter attached to a port that is placed in a pocket made in SQ tissue on chest wall
55
How many sticks can a patient with a portacath located in the chest have?
2000 sticks
56
How many sticks can a patient with a portacath in the arm have?
750
57
What is an advantage for the patient of the portacath?
No tubing, less impact on body image
58
What is the site care for an implanatable port?
None when it isn't being accessed
59
For a portacath, if there is an ongoing infusion how frequent should you change the needle?
Weekly
60
What is a complication of the imported caths?
Catheter occlusion
61
Who will remove the implanted port?
HCP and they must make an incision to remove it
62
What type of CVC is this?
Peripherally inserted central catheter (non-tunneled CVC)
63
Where is a PICC line placed?
At the bedside
64
Who will place a PICC line?
Certified RN, HCP, or radiologist
65
How long do PICC lines last?
3-12 months
66
Where are PICC lines placed on the body?
Typically the antecubital fossa; basilic or cephalic vein
67
What should not be done on the arm that a patient has a PICC line on?
BP readings or blood draws
68
With PICC lines, what complications do you not have?
Puncturing the lung or stickiness around the neck, so less microorganisms
69
What is the site care of a PICC line?
Swab all caps with alcohol Site change day after insertion Site change every Wednesday (at UKHC) or when soiled
70
What are complications of PICC lines?
Phlebitis Occlusions
71
Who removes a PICC line?
Nurse
72
What types of CVCs can be removed by the nurse?
PICC Non-tunneled CVCs
73
How does a nurse remove a PICC line?
Have patient lie or sit down Hold hand below level of heart Have patient bear down while withdrawing Measure length of PICC after removed
74
Why should a nurse remove a PICC line inch by inch/slowly?
If you do it too fast it will cause vein spasms in the arm

Med Surg I (41 decks)

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