Central Venous Catheter Care

Question 1

4 reasons a patient may need a CVC

Answer 1

TPN, chemotherapy, longterm antibiotic use, loss of peripheral access

Question 2

What determines whether a line is peripheral or central?

Answer 2

the location of the tip of the catheter (NOT the insertion site)

Question 3

Veins used for non-tunneled CVC (“deep lines”)

Answer 3

Subclavian (SC), internal jugular (IJ)

Question 4

3 Types of tunneled CVCs

Answer 4

Hickman, Groshong, and Broviac

Question 5

Two other names for implanted ports

Answer 5

“Portacaths” and “PowerPorts”

Question 6

Location of tip of peripherally-inserted central catheter

Answer 6

Right atrium or superior vena cava

Question 7

A primary bloodstream infection that develops in a patient with a central line in place within the 48-hr period before the onset of blood stream infection that is not r/t an infection from another site is called a

Answer 7

Central Line-Associated Blood Stream Infection (CLABSI)

Question 8

TRUE or FALSE: The RN may run 3 incompatible drugs through a triple lumen deep line.

Answer 8

TRUE

Question 9

What is a risk of placing deep line in subclavian

Answer 9

pneumothorax

Question 10

The ____________ prevents atmospheric air from entering the large vessel during the removal of a non-tunneled CVC.

Answer 10

Valsalva Maneuver

Question 11

Advantage of a tunneled CVC

Answer 11

No needle sticks required

Question 12

Disadvantage of a tunneled CVC

Answer 12

Prolonged break in skin integrity

Question 13

Who removes a tunneled CVC?

Answer 13

the HCP

Question 14

The needle used to access an implanted port is called

Answer 14

a non-coring (‘Huber’) needle

Question 15

Primary complication of implanted port

Answer 15

Catheter occlusion

Question 16

True or False: The RN may draw blood out of a PICC?

Answer 16

FALSE

Question 17

2 Advantages of PICC

Answer 17

Less microorganisms on arm

Less insertion complications such as pneumothorax

Question 18

True or False: The RN may remove a PICC?

Answer 18

TRUE

Question 19

Describe how the RN will remove a PICC.

Answer 19

Have patient lie or sit down/hold hand below level of heart & bear down while withdrawing - withdraw inch-by-inch, relaxing catheter after each inch; do NOT pull catheter if vein spasms; measure length of catheter.

Question 20

How often must the access needle be changed for an implanted port with continuous IV fluids?

Answer 20

Weekly