Chapter 16: Parenteral Access Devices Flashcards
Define diameter.
Can refer to the internal or external diameter and is measured in millimeters
Define french size.
A measure of the outer diameter (1 mm = 3 Fr)
Define gauge.
A unit of measure that is inversely proportional to the catheter’s outer diameter
What are the CDC guidelines for peripheral access?
Recommend close monitoring; with the peripheral IV line removed no more frequently than every 72 to 96 hours, unless clinically indicated.
What is purpose of cuffs?
Cuffs attached to CVCs are designed to serve as subcutaneous anchors and mechanical barriers.
What is the most commonly used line for the acute care setting, for short duration?
Nontunneled, noncuffed CVADs; they have a dwell time of 5 to 7 days.
Define CVAD
Central Venous Access Devices
Define PICC.
Peripherally Inserted Central Catheter A catheter inserted via a peripheral vein with the tip in the SVC (superior vena cava); classified as nontunneled
What are the 3 categories of CVADs?
- Nontunneled
- Tunneled
- Implanted
(TRUE/FALSE)
Stabilization devices are necessary to maintain PICC placement and avoid malposition.
TRUE
Describe tunneled central venous catheters, including their advantages.
Silicone elastomer catheter was inserted by subclavian venipuncture, with the distal tip placed in the midatrium; last for months to years
Advantages:
- Ease of self-care by the patient
- Placement on the chest wall so they are covered by clothing
- Decreased risk of dislodgement
- Ability to reapir the external lumen in the event of catheter breakage
Describe TIVADs
Totally Implanted Venous Access Devices (TIVADs)
Consist of silicone or polyurethane catheter attached to a portal reservoir made of stainless steel, polysufone or titanium with a self-sealing silicon elastomer septum
Can be implanted into the subcutaneous pocket in the upper chest, upper arm, or forearm.
What are the patient factors to consider when choosing an appropriate catheter?
- Safe
- Meets the patient’s needs
- Cost-effective
- Type of medication/solution to be delivered
- Overall therapeutic regimen
- Anticipated duration of therapy
- Patient’s lifestyle
- Potential impact of the device on the patient’s body image
- Their activity level
How often should CVADs and mid-line catheters be assessed? For peripheral catheters?
Daily
At least Q 4 hours
What are the appropriate antiseptic agents for cleaning a catheter exit site?
- CHG (chlorheidine gluconate)
- 70% alcohol
- 10% povidone-iodine