CVAD

Question 1

what is the purpose of a CVAD?

Answer 1

• Medication delivery IV
• Nutritional replacement
• Fluid delivery IV
• Blood product delivery IV
• Long term IV therapy
• Poor peripheral IV access
• Frequent blood samples
• Certain types of invasive monitoring (critical care)

Question 2

What are important points about the device?

Answer 2

• catheter tip should be in SVC
• femoral line tip should be in IVC
• x-ray to confirm placement
• has 1-3 lumens
• tunneled (can get infected) or implanted
• use 10cc bcz bigger so less pressure.

Question 3

what are the different lumes used for?

Answer 3

all lumens:
- IV solution and meds. (generally each is used for one thing and labeled)

distal:
- blood administration (largest lumen)

medial:
- TPN (safest location)

proximal:
- blood samples (least contaminated)

Question 4

what are complications of CVAD?

Answer 4

• infection
  -occlusion
• catheter fracture, leak, migration
• air emboli
• pneumothorax/hemothorax

Question 5

what to do if suspected CVAD infection?

Answer 5

• assess pt
• teaching
• C&S of exit site
• catheter and tip for C&S
• CBC
• Blood cultures (x2)

Question 6

what to do if suspected CVAD occlusion?

Answer 6

1) flushing - resistance
2) stop infusion
3) follow hospital protocol
4) notify md

Question 7

what to do if suspected CVAD catheter fracture, leak , migration?

Answer 7

1) stop infusion
2) assess pt and stay w pt
3) notify md

Question 8

what to do if suspected CVAD air emboli?

Answer 8

• clam all lines
• turn pt to LEFT LATERAL, HEAD DOWN
• call for help
• assess pt (VS)
• apply o2
• establish PIV
• continue monitoring

Question 9

what to do if suspected CVAD pneumothorax/hemothorax?

Answer 9

• notify md
• give o2
• assist w catheter removal
• chest tube insertion
• x-ray post insertion