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Interventions > CVAD > Flashcards

CVAD Flashcards

1
Q

factors that determine which vascular access device is used

A
  • length og IV infusion
  • type of medication or product delivered
  • patients healthy and individualized needs
  • least risk of IV complications
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2
Q

what are the 3 type sou vascular access devices? and which ones are considered centrally inserted central lines?

A
  • peripheral venous access
  • middle catheter
  • central venous access devices*
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3
Q

Central venous access devices

A
  • terminal end lies in the central venous system, usually superior vena cava at the cavioartial junction
  • have multiple lumens
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4
Q

used for CVAD

A

-IV fluid
-medications
-blood products
-Total parental nutrition
-chemotherapy
-hemodynamic monitoring
blood sampling

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5
Q

how are CVAD inserted generally?

A

-inserted under ultrasound to decrease insertion related complications, must have an x ray to confirm placement after inserting and before using

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6
Q

complications of CVAD

A
  • CLABSI/ CRBSI
  • air embolism
  • pneumothorax insertion/migration
  • thrombosis: clot
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7
Q

CVAD: peripherally inserted central line

A
  • inserted into deep peripheral vein at antecubital space
  • inserted by certified nurses
  • provides long term venous access
  • less infection and pneumothorax risk than other CVADs
  • chest x ray to confirm placement
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8
Q

CVAD: non tunneled

A
  • can be mutlip lumen are are central catheters
  • inserted into jugular and subclavian
  • short term therapy: 3-10 days
  • high risk for CLABSI and pneumothorax
  • sutured in place
  • usually placed in emergent situations
  • needs dressing
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9
Q

inserted in non tunneled line

A
  • aspetic technique: need a wide sterile field and scrub with 2% chlorhexedine/gluconate
  • CVC impregnanted with chorhexidine based aseptic
  • trendelenburg position
  • cover site with biopatch: transparent dressing or gaze that is only changed if non occlusive, soiled, or bloody
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10
Q

CVAD: tunneled line

A
  • types: groshong, hickman, broviac, Raaf
  • tunneled in SC tissue for 3-6 inches to exit site
  • long term therapy
  • lower risk for CLABSI than nontunneled
  • less visible
  • allows for ease of movement
  • may or may not need dressing
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11
Q

CVAD: implanted port

A
  • long term therapy
  • proximal end implanted into SC tissue of upper chest
  • no visible external ports of lines
  • minimal daily care
  • some discomfort with accessing device
  • tip in subclavian vien
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12
Q

what factors determine choice of line?

A
  • least risk for complications
  • quality of life
  • type of treatment
  • length of treatment
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13
Q

important considerations of CVAD

A
  • always look at policy for care
  • listen to patinas c/o pain: always do exam instead of medication
  • monitor IV site every hour at minimum
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14
Q

assessment of CVAD

A
  • integrity of dressing
  • s/s of infection
  • palpate for tenderness
  • measure length of exposed catheter
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15
Q

flushing a CVAD

A
  • push pause method after every use
  • use 10mL or large syringe
  • 3-5mL NaCl
  • 3mL heparin 100 unit/mL
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16
Q

changing CVAD dressing

A
  • sterile procedure: mask, gown, gloves, and pt mask
  • antimicrobial scrub: over site for 30 sec, 2inch radius, allow to dry
  • changing the caps
  • changing the tubing: every 24 hours for TPN
17
Q

considerations for blood transfusion

A
  • pre assessment
  • patient identification
  • new MD order every 24hrs
  • equipment: y set filtered tubing and normal saline
18
Q

blood transfusion guidelines

A
  • remain at bedside of 5-15 minutes
  • infuse slowly (25-50mL) for first 5-15 minutes
  • 4 hours maximum infusion time for PRBC
19
Q

blood transfusions vitals

A
  • before starting: VS and physical assessment

- every 5minutes 3 times, every 15 minutes 3 times, and every 30 minutes until complete

20
Q

transfusion reaction symptoms

A

Allergic reaction: -hives, itching, anaphylaxis
Febrile reaction: -fever, chills, malaise,
hemolytic reaction: -immediate onset of fail flushing, chills, headache, low back pain, shock
Circulatory overload: -dyspnea, dry cough, pulmonary edema
Bacterial infection: hypertension, fever, flushed skin, abdominal pain

21
Q

purpose of adding medication to a primary bag

A
  • patient received the mediation slowly over long period of time
  • typically mixed in the pharmacy bu can be done on unit
22
Q

purpose of adding medications into secondary line/piggyback

A
  • administer a medication intermittently during 24 hour period into primary line IV
  • medication is mixed in 50-100mL
23
Q

purpose of IV push through primary line

A
  • deliver a single injection of medication directly into he vein to produce a rapid serum concentration
  • use the port closest to the needle insertion sit
24
Q

purpose of administering meds via mini infusion pump

A
  • deliver meds in a small and controlled amounts over a prescribed period of time
  • frequently used with children, older adults, and patients with cardiovascular problems
25
Q

purpose of volume controlled infusion

A
  • deliver meds or fluid in small amounts to patient with fluid balance concerns
  • used in children, older adults, those on fluid restriction, and critically ill where volume control is important
26
Q

purpose of IV push or intermittent infusion via lock

A
  • deliver meds in a short period of time directly into the vein
  • flush lock before and after with 2-3 NaCl: positive pressure method and pulsatile method

Interventions (8 decks)

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