Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics > Central Venous Access Devices > Flashcards

Central Venous Access Devices Flashcards

1
Q

What are the different types of CVAD?

A
  1. Non-tunneled catheters
  2. Tunneled catheters
  3. Implanted vascular devices
  4. Peripherally inserted central catheters (PICCs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Non-tunneled catheter location

A
  1. Placed in central vein via subclavian or internal jugular vein
  2. In peds can be placed in groin in PICU setting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tunneled catheter location

A

Under the skin then threaded into a central vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Implanted vascular device location

A

Device under the skin with catheter into a central vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PICC location

A

Threaded through a peripheral vein into the central circulation/vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CVAD indications

A
  1. Infusion of concentrated solutions: TPN of [Dextrose/Glucose] > 15-25%
  2. Vasoactive medications such as dopamine and dobutamine
  3. Blood products - generally over longer term or larger volumes quickly - often in emergency situations
  4. Poor or limited peripheral venous access i.e., for longer term antibiotics or blood draws
  5. Long-term medication or chemotherapy/other vesicant or irritating solutions
  6. Hemodialysis - generally short term
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the maximum concentration of dextrose that can be infused peripherally?

A

12.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What happens with negative pressure in a Groshong catheter?

A

Negative pressure opens valve inward permitting blood aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens with positive pressure in a Groshong catheter?

A

Positive pressure opens valve outward allowing infusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What happens with neutral pressure in a Groshong catheter?

A

At neutral pressure valve remains closed, reducing risk of air embolism, blood reflux, and clotting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Do closed-ended catheters require heparin?

A

No!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Uses for non-tunneled catheter

A
  1. To administer large volumes and multiple fluids
  2. Vasoactive medications, antibiotics, blood products, TPN
  3. Obtain blood samples
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What should always be done before using a central line after it has been placed?

A

Obtain a chest x-ray to confirm placement of catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indications for PICC lines

A
  1. Kept of longer periods of time
  2. Antibiotics
  3. Hydration
  4. Pain management
  5. Infusion of hyperosmolar/hypertonic fluids
  6. Hyperalimentation (TPN)
  7. Some types of chemotherapy
  8. Continuous home inotropic therapy (milrinone, dobutamine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Advantages of PICCs

A
  1. Useful for acute care and home care
  2. Permits freedom of movement
  3. Small, flexible, useful in young or elderly
  4. Used to administer fluid and blood draws (if lumen large enough)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications for dialysis catheter

A
  1. Acute renal failure
  2. Overdoses
  3. Need maturation of a dialysis fistula or graft
  4. Use as a bridge during transplantation
  5. Permanent access in those patients who have been depleted of dialysis sites
17
Q

Disadvantages of dialysis catheters

A
  1. Hard to maintain over a long time frame
18
Q

Indications for IVAD (Medi-Port)

A
  1. Access site for obtaining blood samples
  2. Cyclic therapies such as chemotherapy, antibiotics
  3. Treatments for chronic or long-term illnesses, such as cancer or cystic fibrosis
19
Q

Advantages for IVAD

A
  1. Can handle both bolus injections and continuous infusions

2. Can draw blood from

20
Q

Who can access an IVAD?

A

Certified nurses

21
Q

Advantages of tunneled catheters

A
  1. Provides stability

2. May protect against endovascular infection from the skin

22
Q

Indications for tunneled catheters

A
  1. Chemotherapy
  2. Long-term nutritional support
  3. Long-term or intermittent therapies
23
Q

Complications of CVACs

A
  1. Thrombosis
  2. Infection
  3. Air embolism
24
Q

Signs/symptoms of thrombosis

A
  1. Swelling, warmth, tenderness of extremity beyond insertion site
  2. Cyanosis of face
  3. Development of collateral (extra) vessels

Note: diagnosis is made by ultrasound, venogram, or CT angiography

25
Q

Infection

A

Fever, increased WBC, erythema, tenderness at catheter site, purulent drainage

26
Q

What is an acute infection of a CVAC and what is the common cause?

A

Occurs 3-5 days after insertion often due to contamination during the insertion procedure

27
Q

What is a delayed infection of an CVAC and what is the common cause?

A

An infection that occurs more than 5 days after central access device placement commonly caused by staph. aureus.

28
Q

What are the signs/symptoms of an air embolism?

A
  1. Respiratory distress
  2. Increased heart rate
  3. Cyanosis
  4. Decrease in blood pressure
  5. Sudden change in LOC (often first indicator that something is wrong)
  6. Back or shoulder pain
  7. Churning murmur over precordium
29
Q

What should you do if there is an air embolism?

A
  1. STAY WITH PATIENT
  2. CALL FOR HELLP
  3. Administer oxygen
  4. Pinch off catheter if still in place
  5. Cover any open of disconnected catheter ports
  6. Place patient on left side in Trendelenberg position (helps keep air in right atrium)
30
Q

How should you care/manage central lines?

A
  1. Care by “bundle” aspects
  2. Daily assessment
  3. Aseptic technique
  4. Maintain an occlusive dressing
  5. Minimize breaks in lines/maintain patency
  6. Vigorous scrubs of all hubs
  7. Timely tubing changes
31
Q

How often should you change the dressing of a central line?

A
  1. Whenever the dressing is loose, wet, or non-occlusive

2. Otherwise, every 7 days if covered by Tegaderm

32
Q

What size syringe should you use with a central line?

A

10 mL or larger

Therapeutics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions