Central Venous Access Devices (CVAD) Flashcards
what are the indications for CVAD?
for long term therapy/short term
infusion of vesicants/TPN
greater risk of complications: infection, necrosis, infiltrations, phlebitis, CFH, electrolyte imbalances
chemotherapy
blood
antibiotics
IV meds/solutions
CVP monitoring
hemodialysis
infiltration
tear in the blood vessel, fluid leaks and gets swollen, can lead to necrosis
phlebitis
inflammation of the vein
what are CVAD?
devices in the large veins in central circulation that allow for admin of IV fluids, blood, meds
inserted in the SCV/JV
placement checked by XRAY
single lumen CVAD
if used for TPN= do not use for blood
need infusion into large central vein
multiple lumen CVAD
2-5 ports
solutions do not mix
different ports for different meds
to monitor central venous pressure= indicate fluid overload, dehydration
DL: blood/fluis
ML: parenteral
PL: med/blood
what is a risk factor for CVAD?
pneumothorax: air in pleural space outside the lung caused by a puncture
absence of lung sounds, tracheal deviation, SOB
what are the 4 types of CVAD?
- non-tunneled central catheters
- tunneled catheters
- implanted ports
- peripheral inserted central catheters (PICC)
non-tunneled central catheter
higher chance of infection
short term
risk for CABI
straight into the vessel into the right atrium
tunneled catheter
long term, under the skin to find vessel
6 inches before vessel
less chance of infection
administer fluids, chemo, antibiotics, blood, parenteral nutrition
implanted port
long-term, for life
less chance of infection
use non-coring Huber needle
flush with heparin
peripherally inserted central catheters (PICC)
inserted in the basilic/cephalic vein of the arm
measure the length to monitor
indicated for diabetes, osteomyelitis, IV therapy
long term
no srynges less than 10ml= can cause catheter rupture/fragmentation/embolization
care: dressing change 24 hours after insertion, then weekly, look for redness, swelling, drainage, pain, ipsilateral swelling, arm circumference change
education: avoid heavy lifting, keep dry
complications: phlebitis, thrombophlebitis, CLABSI
contra: sclerotic vein, mastectomy, radial artery surgery, hemodialysis graft, fistula
guidelines for CVAD
document date, site, brand, gauge, catheter length, number
strict aseptic technique for site care
frequency of dressing changes (7 days)
-change when loose or soiled
assess site for redness, swelling, tenderness, drainage
CVAD care and flushing
change catheter cap per protocol
- more piercing= more chance of infection
use 10ml to flush with a 0.9% solution = prevents clots, do not force in (cause pulmonary embolism)
-before and after use
patient teaching of CVAD
no BP on arm with PICC line
implanted ports can be dislodged
signs
-pain in the neck or ear, affected side
-palpitations
-swelling
-difficulty accessing port
