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Module 2 Exam 1 > CVAD > Flashcards

CVAD Flashcards

1
Q

Wha tis a CVAD?

A

Central Venous Access Device: Allows for administration of things directly into the Superior Vena Cava/Heart

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2
Q

Whatre the 3 lumens coming from the one Catheter on the CVAD used for/

A

Distal: Blood draws/infusions, meds and CVP
Medial: TPN (Thick nutritional substance)
Proximal: IV Fluids, meds

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3
Q

Where do you insert a CVAD and where does it lead?

A

Insert into a large central vein to lead to the superior vena cava/right atrium

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4
Q

How do you confirm the placement of a CVAD?

A

X ray

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5
Q

Why are we slightly moving away from the use of a CVAD?

A

High infection rate

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6
Q

How long are CVADs used for typically?

A

Moderate-long term use

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7
Q

Indications/Reasons for CVADs?

A
  • Need for multiple intravenous access
  • Hemodialysis
  • TPN
  • Chemo
  • Multiple blood transfusion/blood draws
  • Long term antibiotics/IV meds
  • Central Venous Pressure monitoring
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8
Q

What is different about the numbers for measuring lumens’ sizes?

A

Smaller numbers mean bigger

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9
Q

What should we tell the patient when working with CVADS?

A
  • Purpose: what will be administered
  • Estimated length of time of how long they’ll have the CVAD
  • Inform that it is a sterile procedure and what to expect because of it
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10
Q

What is needed for CVAD insertion?

A
  • Doctors orders and Signed Consent of pt
  • Pre and post Vitals
  • Sterile Mindset
  • Pt in trendelburg position
  • PICC team
  • Xray Confirmation
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11
Q

Why do we put pt’s in the trendelenburg position for CVAD insertion?

A

It enlarges the veins to make insertion easier and to lower the chance of an air embolism

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12
Q

What are the 3 types of CVADs?
Which one is the most common?

A
  • Non tunneled (Most common)
  • Tunneled
  • Port a cath
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13
Q

Where does a Non tunneled CVAD go?

A

-Directly into with the Subclavian, Jugular, Femoral, or Peripheral vein

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14
Q

How long are non tunneled CVADs used for?

A

~ 6 weeks

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15
Q

How are non tunneled catheters secured?

A

Sutures outside of the insertion site to the skin

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16
Q

Why do non tunneled CVADS have a higher infection rate?

A

There’s a direct opening into the skin

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17
Q

Why can nurses discontinue CVADs?

A

Cause they were not surgically implanted

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18
Q

What does PICC stand for?

A

Peripherally Inserted Central Catheter

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19
Q

Where are PICC lines inserted?

A

The two peripheral veins, Basilic or Cephalic, whichever can be assessed

20
Q

Why can you not do phlebotomy or take BP in arms with a PICC line?

A

PICC lines are in the way to take BP and PICC lines can be used to draw blood as well

21
Q

How are Tunneled CVADs implemented?

A

They’re surgically implaneted beneath the skin

22
Q

How are tunneled Catheters unique?

A

there is a Dacron Cuff on the catheter

23
Q

How is the Dacron Cuff secured?

A

Placed SubQ and then secured when scar tissue forms around it

24
Q

Common sites for Tunneled CVADs.

A

Subclavian Vein, IJ, and Femoral Vein

25
Q

How long are Tunneled CVADs for?

A

Chronically/Longterm (Greater than 6 weeks)

26
Q

Tunneled CVADs have multiple-

A

Ports

27
Q

Can Nurse discontinue Tunneled CVADs?

A

No, they must be surgically removed

28
Q

How are implanted ports(Port a cath) inserted?

A

Surgically implanted beneath the skin.

29
Q

Where are Implanted ports located?

A

Tunneled through the jugular, subclavian, or cephalic/basilic veins

30
Q

How long are Implanted Ports used for?

A

Months to years

31
Q

How do you access Implanted ports?

A

Huber needle

32
Q

Implanted ports are less-

A

Restrictive, theyre under the skin when healed so there’s no obstruction

33
Q

5 knowledge and care protocols for CVADS

A
  • Always assess the CVAD site before any intervention
  • Always Scrub for at least 15 seconds
  • Always program CVAD infusions to a pump
  • Flush Lumens using only 10mL syringes
  • Change Dressings 24 hours after insertion and then q 7 days and PRN
34
Q

What do you assess for when looking at CVAD insertions?

A
  • Sutures and dressing and their dates
  • Lumens, Clamps, and Caps
  • Fluids/Meds
35
Q

When should you flush Lumens?

A
  • q Shift
  • After every Med
  • After every blood draw
36
Q

What is CLABSI?

A

Central Lab Associated Blood Stream Infection (The most common complication with CVADs)

37
Q

Signs and Symptoms of CLABSI

A
  • Redness
  • Drainage
  • Swelling
  • Discomfort
  • Fever
  • Chills
  • Tachycardia
  • High WBC count
38
Q

How to prevent CLABSI?

A
  • Strict Asepsis
  • Never touch with bare hands
  • Clean with alcohol swab before EVERY access
  • Assessments and report concerns
  • Change dressings as indicated
  • Pt/family teaching
39
Q

Signs and Symptoms of a pneumothorax

A
  • Dyspnea
  • Hypoxia
  • Tachycardia
  • Restlessness
  • Cyanosis
  • Chest pain
  • Lower breath sounds
  • Chest deformaties
40
Q

Interventions for pneumothorax

A
  • Monitor Vital
  • Give O2
  • Notify physician, CN, RRT
  • Give chest tube if indicated
41
Q

Signs and Symptoms of a Venous air embolism

A
  • Dyspnea
  • Chest pain
  • Headache
  • Confusion
  • Hypotension
  • Hypoxia
  • Tachycardia
42
Q

Nursing interventions for Venous air embolisms

A
  • Keep Lumens Clamped
  • Give O2
  • Monitor Vitals
  • Place pt on left lateral side in Trendelenburg position
43
Q

For a pt with a Venous air embolism, why do we place them how we do?

A

Tries to keep the air embolism trapped

44
Q

4 other complications of CVADs?

A
  • Occlusion: Lack of blood return or sluggish flow
  • Thrombosis: Clot that blocks lumens
  • Catheter Rupture: May be caused by excessive force while flushing with wrong syringe
  • Catheter Migration: Displacement or lengthening of catheter
45
Q
A

Module 2 Exam 1 (4 decks)

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