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NURS 470 > Central Venous Catheters > Flashcards

Central Venous Catheters Flashcards

1
Q

Where do most central lines terminate?

A

Superior vena cava

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2
Q

What should be monitored once a central line is placed?

A

arrhythmias, infection, pain

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3
Q

Where are early signs of central line infections seen?

A

at the site

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4
Q

What are two reasons that patients need a central line put in?

A

poor peripheral venous access or for long-term IV therapeutics

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5
Q

What are examples of reasons that a patient may have a central line for long-term IV therapy?

A

high volume fluid administration, medication administration (electrolyte replacement, anti-invectives, chemotherapy), blood transfusions, vasopressors, TPN, plasmapheresis/dialysis

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6
Q

Where is a tunneled CVC placed? Non-tunneled?

A

OR vs bedside

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7
Q

what is the most common CVC that is placed?

A

triple lumen catheter: 7 french

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8
Q

What are examples of non-tunneled CVCs?

A

PICC, IJ, Subclavian, Vascath

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9
Q

What is an example of an implanted CVC?

A

Port-a-cath (PAC)

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10
Q

What are examples of tunneled CVCs?

A

Hickman, Broviac, PICC, Subclavian, Permcath

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11
Q

How can CVCs be assessed for patency?

A

Saline flush and blood return

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12
Q

What can PIVs be used for?

A

high flow IV fluids, blood products, IV push drugs, and electrolyte replacement

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13
Q

How is a non-tunneled IJ kept in place?

A

sutured

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14
Q

How are PICC lines anchored?

A

stitches or StatLock

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15
Q

How are PICC lines flushed?

A

10mL saline flush

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16
Q

How are PICC lines advanced?

A

with a guide wire

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17
Q

Before using a CVC, what is important to check?

A

Chest x-ray has confirmed placement and there is an order by the doctor

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18
Q

What is the biggest complications for CVCs?

A

DVT

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19
Q

What is a daily assessment for a PICC line in order to ensure a DVT hasn’t formed?

A

upper arm circumference

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20
Q

When is a femoral catheter used?

A

In trauma situations and immobile patients

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21
Q

Why do you not need x-ray confirmation to ensure placement of a femoral catheter?

A

It terminates at the inferior vena cava

22
Q

What color are the catheters for dialysis?

A

red and blue

23
Q

What kind of needles need to be used for an implanted port-a-cath?

A

non-coring needles (huber)

24
Q

When are port-a-caths most often used?

A

for cancer patients

25
Q

What would a power port be used for?

A

Rapid injection or CT/MRI with contrast

26
Q

What is important to place on a central line for infection prevention?

A

biopatch

27
Q

How are tunneled central lines anchored?

A

1-2 cuffs

28
Q

Who inserts a tunneled central lines?

A

interventional radiology or operating room

29
Q

What is a two lumen red and blue line with 1-2 cuffs called?

A

hickman line (tunneled)

30
Q

What is the purpose of cuffs on a hickman line?

A

inhibit microbial growth

31
Q

What is a triple lumen colored red white and blue called?

A

VasCath

32
Q

What influences the selection of CVCs?

A

Patient characteristics and preferences, patient history and co-morbidities, infusion needs, CVC options (tunneled vs non-tunneled, implanted port)

33
Q

What can daily site care of a tunneled line increase the chance of?

A

infection

34
Q

What should be assessed on a tunneled line daily?

A

patency, cleanliness, blood return, pain, swelling, integrity of the line

35
Q

What is included in a CVC assessment?

A

insertion site, exit site (redness, swelling), patency of each line, integrity of each line, clamps and caps, creates on chest, and pain in arm, shoulder, or neck

36
Q

What is the common policy for CVC line maintenance if there is no running IV?

A

SASH (Saline, Administer, Saline, Heparin)

37
Q

Why is a 10mL syringe always used for CVCs?

A

it decreases pressure in the catheter

38
Q

How should IV fluids be administered using a central line?

A

on a pump

39
Q

What are the potential complications of CVC insertion?

A

Pneumothorax, hematoma, infection, air embolism, wrong vein

40
Q

What is the average cost for each CVC infection?

A

$46000

41
Q

What kind of event is a vascular catheter-associated infection?

A

“never event”

42
Q

Best practices for preventing CVC infections? (the central line bundle)

A

Hand hygiene, maximum barrier precautions upon insertion, chlorhexadine, optimal catheter site selection (avoid femoral), daily review of need for a central line

43
Q

When should a CVC dressing be changed?

A

when damp, loosened, or soiled

44
Q

How often should a transparent CVC dressing be changed?

A

every 7 days

45
Q

How often should gauze be changed for CVCs?

A

every 24 hours

46
Q

What kind of technique is important to use to prevent catheter-related blood stream infections?

A

sterile technique

47
Q

What should be used at the exit site?

A

Biopatch

48
Q

What should be used for prep for a CVC dressing?

A

clorhexidine/alcohol prep with friction

49
Q

How long should the hubs be scrubbed for?

A

15-30 seconds

50
Q

4 complications of CVCs

A

intraluminal occlusion, fibrin formation, venous thrombosis, drug precipitation

NURS 470 (33 decks)

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