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IM 2 Exam 1 > CVAD > Flashcards

CVAD Flashcards

1
Q

3 Types of CVADs

A
  1. Non-tunneled
  2. Tunneled
  3. Port-a-cath
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2
Q

What is a PICC line

A

a Peripherally inserted central catheter

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3
Q

Which of the 3 types is at a higher risk of infection

A

Non-tunneled

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4
Q

With Non-tunneled and Tunneled CVADs, how are they removed?

A

Non-tunneled- nurses can take out
Tunneled- must be surgically removed

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5
Q

Out of the 3 types of CVADs, how long do they normally stay in?

A

Non-tunneled: 6wks
Tunneled: >6wks
Port-a-cath: months to years

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6
Q

Which veins in the arm are used for PICC

A

The Basilic or cephalic vein

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7
Q

Who can place PICC lines? (2)

A

The PICC team or IR

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8
Q

What cannot be done on an arm with a PICC line (2)

A

Phlebotomy or blood pressures

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9
Q

What CVADs type uses a Dacron cuff

A

A tunneled CVAD

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10
Q

What does a Dacron cuff help? (2)

A

It helps secure the catheter and helps prevent infection

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11
Q

Which CVAD type is sutured in?

A

The tunneled and non-tunneled

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12
Q

Which type of CVAD is the least restrictive ?

A

Port-a-cath

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13
Q

What type of needle is needed for a Port-a-cath

A

A Huber Needle

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14
Q

How do you confirm a CVAD Placement

A

X-ray

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15
Q

Where was the catheter tip ended?

A

The superior vena cava

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16
Q

What are 3 things to inspect the insertion site for?

A

S/S of infection
Displacement
Sutures

17
Q

What is the distal lumen used for? (4)

A

Blood draws, blood infusions, meds, Central venous pressures (CVP)

18
Q

What is the proximal lumen used for? (3)

A

IV fluids, meds, blood draws

19
Q

What is the medial lumen used for? (1)

A

TPN

20
Q

What are some complications of CVADs ?(7)

A
  • infections (CLABSI): Central Line-associated Bloodstream infection
  • Pneumothorax: Air in the pleural space outside the lung
  • Air embolism:- Air entering the circulatory system
  • Occlusion- Lack of blood return or sluggish flow
  • Thrombosis: Clot that blocks the catheters lumen
  • Catheter Rupture: May be caused by excessive force used while flushing
  • Catheter Migration : Catheter displacement
21
Q

S/S of CLABSI (8)

A

-Redness
-Drainage
-Swelling
- Discomfort at insertion site
- Fever
- Chills
-tachycardia
- Leukocytosis

22
Q

S/S of Pneumothorax (7)

A
  • dyspena
  • Hypoxia
  • Tachycardia
    -Restlessness
    -cyanosis
    -chest pain
    -decreased breath sounds
23
Q

Nursing interventions for Pneumothorax (4)

A
  • Monitor Vs
    -Administer O2
  • Notify Dr., CN, RRT
  • Prepare for chest tube if indicated
24
Q

S/S of Air embolism (6)

A

Dyspnea, chest pain, tachycardia, hypotension, anxiety, and nausea

25
Q

Nursing Interventions for air embolism (4)

A
  • Keep lumen clamped
  • Administer oxygen, monitor Vs, Pulse ox
  • Place patient on left lateral side in trendelenburg position
  • stay with the patient and notify Dr, CN, and RRT
26
Q

Nursing interventions for catheter occlusion (6)

A
  • Take deep breaths/ cough
  • Raise arms overhead and reposition arm on sam side as the catheter
  • Have patient sit up/stand up
  • change positions in bed
  • Place in trendelenburg
  • Administer alteplase
27
Q

When do you assess the CVAD site

A

Before any interventions

28
Q

When do you scrub the hub for?

A

15 seconds

29
Q

When do you scrub the hub?

A

Before you access the lumen

30
Q

What do you program a CVAD infusion to

A

A pump

31
Q

What mL syringe do you use to flush a lumen

A

A 10 ml syringe

32
Q

When do you flush the lumens? (3)

A

After every medication
After every blood draw
Every shift

33
Q

when do you do a dressing change for a CVAD? (3)

A

24 hour post-insertion & every 7 days or PRN

34
Q

When do you change the Max-Zero caps?(2)

A

Every 7 days or PRN

35
Q

What angle should the HOB be for a dressing change be

A

30

36
Q

What must you do before performing a dressing change

A

Assess the site, lumens, and clamps

37
Q

Steps to Removing a CVAD catheter (8)

A
  1. Get a Dr.’s order, CVAD kit, Suture removal kit, petrolem based gauze
  2. Clip sutures
  3. Hold Breath & Pull line out
  4. Hold pressure 5 minutes or until bleeding stops
  5. Apply Petroleum gauze to insertion site
  6. Cover with occlusion dressing & leave on for 24 hours
  7. Remain supine at least 30 mins
  8. Document + patient teaching
38
Q

PICC line removal steps (9)

A
  1. Get a Dr.’s order, CVAD kit, Suture removal kit, petrolem based gauze
  2. Clip sutures
  3. Hold Breath & Pull line out measure catheter length of PICC line
  4. Hold pressure 5 minutes or until bleeding stops
  5. Apply Petroleum gauze to insertion site
  6. Cover with occlusion dressing and 4x4 gauze. Cover that with coban & leave on for 48 hours.
  7. Remain in supine for 30 mintues
    8 document and patient teach
  8. Monitor for complications

IM 2 Exam 1 (5 decks)

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