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PCM III > cardiovascular procedures > Flashcards

cardiovascular procedures Flashcards

1
Q

Indications of venipuncture

A
  • Health screening
  • Pre-operative evaulation
  • Diagnostic aid –> most common
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2
Q

Relative contraindications of venipuncture

A
  • Patient inability to sit still (young child)

- Skin conditions interfering with access

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3
Q

Complications of venipuncture

A
  • Bleeding
  • Infection
  • Arterial/nerve injury
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4
Q

Site selection and preparation of venipuncture

A
  • Assemble all supplies first
  • Position patient: straighten arm with elbow resting on flat surface
  • Apply tourniquet above antecubital fossa
  • Distend veins by having pt open and close fist several times
  • Choose a vein that is distended
  • Clean with alcohol swab in concentric circles starting from the center and working out
  • Don’t repalpate the clean area
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5
Q

Most common site for venipuncture

A

median cubital vein

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6
Q

Angle to insert needle for venipuncture

A

15-30 degress

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7
Q

When do you release the tourniquet

A

Before removing the needle

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8
Q

Indications for intravenous catheterization

A

Administration of fluids and medications

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9
Q

Relative contraindications for IV

A
  • Pt inability to sit still

- Skin conditions interfering with access

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10
Q

Complications of IV

A
  • Bleeding (bruising, hematoma)
  • Infiltration of fluid into subcutaneous tissue
  • Infection
  • Thrombus
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11
Q

preparation for IV

A
  • Assemble all supplies first
  • Connect IV tubing to the solution bag and allow the fluid to run through the tubing, eliminating all the air (priming the tubing), then clamp line closed
  • Tear several pieces of tape, 4-6 inches in length and place them nearby
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12
Q

Veins for IV

A

Basilic or cephalic on the dorsal forearm are preferred

  • Metacarpal veins on the dorsum of the hand are the easiest to visualize, but are more likely to occlude and are prong to infiltration
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13
Q

Sites to avoid for IV

A
  • Areas of flexion and bony prominences- antecubital fossa- emergencies only
  • Near multiple valves, branches
  • Pre existing catheter sites
  • Ipsilateral mastecomy and/or lymph node dissection
  • Ipsilateral arteriovenous fistula or graft
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14
Q

Local anethetic

A

Lidocaine

causes more pain to administer than starting IV

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15
Q

When should you remove the catheter and start over for an IV?

A
  • The pt complains of pain or burning
  • The skin appears to be swelling
  • There is not good flow in the drip chamber
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16
Q

central line indications

A
  • Inability to maintain peripheral venous access
  • Need to access to central circulation- pacemaker or pulmonary artery catheter
  • Infusion of hypertonic or substances that cause sclerosis of peripheral veins
  • Hemodialysis
17
Q

central venous catheter contraindications

A
  • contralateral pneumonectomy
  • bleeding diathesis
  • operator inexperience
  • infection at insertion site
  • recent placement of pacemaker
18
Q

central line complications

A
  • Arterial puncture
  • Pneumonthorax
  • Thrombosis
  • Infection
  • Cardiac dysrhythmia
19
Q

Where can a central line be placed?

A

subclavian or central jugular vein

20
Q

EKG indications

A
  • Chest pain of suspective cardiac origin
  • Suspected arrhythmia
  • Screening for cardiac conditions
  • Pre-operative evaluaiton
21
Q

EKG contraindications

A
  • Pt inability to sit still
  • Skin conditions interfering with lead placement
  • Need for basic life support
22
Q

EKG complications

A
  • Skin reaction to adhesive

- Incorrect interpretation of results

23
Q

What are the 12 EKG leads

A
  • 3 standard limb leads
  • 3 augmented limb leads
  • 6 pre cordial leads
24
Q

limb lead placement

A

White = right and smoke over fire

right arm- white
left arm- black
left leg- red

25
Q

Chest electrode placement

A
  • V1- 4th ICS at right sternal border
  • V2- 4th ICS at left sternal border

Skip V3 for now

  • V4- 5th ICS at midclavicular line
  • V3- halway b/w V2 and V4
  • V5- anterior axillary line at the same level as V4
  • V6- midaxillary line at the same level as V4 and V5

PCM III (13 decks)

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