Central lines Flashcards

1
Q

purpose of central lines

A

his osmolarity IV therapy, prolonged therapy, frequent blood work and transfusions, pressure monitoring, incompatible meds

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2
Q

high osmolarity therapy percentage requiring central line

A

more than 10% dextrose, 5% protein electrolytes, TPN, hypertonic solutions

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3
Q

hypertonic solutions

A

D5 NS
D5 LR
D10 W
D5 1/2 NS
3% NaCl
25% albumin

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4
Q

PICC

A

peripheral inserted central catheter
- good for up to a year
- can be inserted at bedside or surgically
- X-ray required prior to use

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5
Q

best location site for PICC

A

basilic
- on upper arm; ulnar side

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6
Q

open picc line

A

“power picc” “arrow”
- has clamps

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7
Q

closed picc line

A

“groshong” “power picc solo”
- has valve
- no clamps

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8
Q

locations for central lines

A

basilic, brachial, cephalic, peripheral, internal jugular, subclavian
- all rest in superior vena cava

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9
Q

non-tunneled central line

A

short term
- multiple lumens
- highest risk of infection

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10
Q

non-tunneled central line use

A

urgent and short term

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11
Q

non-tunneled central line insertion

A

inserted at bedside but require x-ray prior to use

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12
Q

tunneled central line

A

secured via dacron cuff and fibrous tissues grows into it
- lowest risk of infection
- named as “broviac” or “hickman”

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13
Q

tunneled central line use

A

long term (1-3 years)

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14
Q

tunneled central line placement

A

requires surgical placement and removal

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15
Q

IVAD

A

inserted in the OR and is placed under the skin
- long term (1-3) years

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16
Q

accessing IVAD

A

only access using huber point needle

17
Q

needle change for IVAD if accessed

A

needle must be changed every 7 days

18
Q

needle change for IVAD if not accessed

A

needle must be changed every 30 days

19
Q

dressing change

A

measure to make sure line dosent move
- change every 7 days using tegaderm and 24 hours post insertion
- sterile technique

20
Q

site assessment frequency for central line

A

assess every 4 hours when inserted and after that every shift

21
Q

indications for flushing

A

before infusions, prior to meds, blood sampling, after disconnection, prior to locking
- flush with 20ml

22
Q

locking frequency for non tunneled

A

every 24 hours

23
Q

locking frequency for tunneled

A

every 7 days

24
Q

locking frequency for picc

A

every 24 hours

25
locking frequency for IVAD
every 30 days
26
flushing solution for closed PICC and tunneled
NS 10ml
27
flushing solution for non valved
NS 10ml, heparin 5ml, sodium citrate 3ml
28
cap connector change
no more than 4 days and at least every 7 days - prior to collection of blood culture from CVAD
29
pinch off syndrome
get stuck between clavicle and first rib
30
S&S of pinch off syndrome
positional occlusion, difficulty flushing/aspirating
31
treatment for pinch off syndrome
raise arm and forceful flush
32
catheter valves
reduce risk of blood reflux and occlusion
33
distal port of multilumen CVAD
longest tube; 18 gauge - CVP monitoring
34
medial port of multilumen CVAD
18 gauge; "meals" - where we put TPN - or medication if not on TPN
35
proximal port of multilumen CVAD
shortest tube; 16 gauge; "poke" - blood sampling - put medication in - blood administration