CV Procedures

Question 1

Venipuncture indications/contraindications

Answer 1

I: health screen, pre-op eval, dx aid
CI: inability to sit still, skin condition (cellulitis)

complications= bleeding, infection, arterial and nerve injury

Question 2

venipuncture procedure

Answer 2

apply band, find vein, clean and glove
pull traction on skin distal to site, insert needle at 15-30deg until you see flashback of blood

if no flashback, partially with draw and re-advance

release tourniquet before removing needle

Question 3

IV catheterization indications

Answer 3

Indications:

Administration of fluids and medications

Question 4

IV cath contraindications and complications

Answer 4

Relative contraindications
Patient inability to sit still
Skin conditions interfering with access

Complications
Bleeding (bruising, hematoma)
Infiltration of fluid into subcutaneous tissue
Infection
Thrombosis

Question 5

selecting an IV cath site

Answer 5

Basilic or cephalic veins on the dorsal forearm are preferred
Metacarpal veins on the dorsum of the hand are the easiest to visualize, but are more likely to occlude and are prone to infiltration
antecubital fossa for emergency

Question 6

IV cath procedure

Answer 6

1. tie tourniquet using slip knot
2. Clean
3. Hold cath bw thumb and middle finger with index on top, insert at 30 deg with bevel facing up
   4) Continue until you feel a pop and see a flashback
   5) lower angle of needle and advance 3-5mm
   6) slowly advance the cath sleeve
   7) withdraw needle, occlude blood flow
   8) remove tourniquet

Question 7

IV cath-how you know you missed the vein

Answer 7

If the patient complains of pain or burning, the skin appears to be swelling or there is not good flow from the IV bag

Question 8

Central Venous Cath (Central Line)indications

Answer 8

Indications:
inability to maintain peripheral venous access
need to access to central circulation, pacemaker or pulmonary a. cath

infusion of hypertonic substance that would cause sclerosis of peripheral veins (TPN or chemo)

hemodialysis

Question 9

Central Venous Cath (Central Line) contraindications

Answer 9

Contralateral pneumonectomy 
Bleeding diathesis
Operator inexperience
Infection at insertion site
Recent placement of pacemaker

Question 10

Central Venous Cath (Central Line) complications

Answer 10

Arterial puncture
Pneumothorax 
Thrombosis 
Infection 
Cardiac dysrhythmia