CVAD/CPN Flashcards
What is Parenteral Nutrition (PN), and how does it differ from enteral nutrition?
PN is a method of delivering nutrients intravenously, bypassing the digestive system, used when oral or enteral nutrition is not possible.
What are the main components of a typical PN solution?
Carbohydrates (usually as dextrose), amino acids, lipids, electrolytes, vitamins, and trace elements.
When is PN indicated for patients?
PN is indicated when a patient cannot meet nutritional needs via the gastrointestinal tract, such as in cases of bowel obstruction, severe pancreatitis, or short bowel syndrome.
What are the differences between total parenteral nutrition (TPN) and peripheral parenteral nutrition (PPN)?
TPN is administered through a central vein, providing complete nutritional support, while PPN is administered through a peripheral vein and is typically used for short-term, less concentrated nutritional support
What is refeeding syndrome, and why is it a concern with PN?
Refeeding syndrome is a potentially fatal shift in fluids and electrolytes that can occur when feeding is reintroduced after a period of malnutrition, particularly with rapid initiation of PN.
Why is monitoring blood glucose important in patients on PN?
PN solutions often contain high levels of dextrose, which can lead to hyperglycemia, so regular blood glucose monitoring is essential to manage this risk
What immediate steps should be taken if a patient’s Parenteral Nutrition (PN) solution runs out before the next bag is available?
dextrose 10% in water
A patient with a newly inserted CVAD reports sudden shortness of breath and chest pain. The nurse suspects an air embolism. What should be the nurse’s immediate action?
A) Place the patient in a supine position
B) Clamp the CVAD catheter and place the patient in the left lateral Trendelenburg position
C) Notify the healthcare provider and prepare for chest tube insertion
D) Administer oxygen at 2 L/min via nasal cannula
B) Clamp the CVAD catheter and place the patient in the left lateral Trendelenburg position
Rationale: Clamping the catheter prevents further air entry, and the left lateral Trendelenburg position helps trap the air embolism in the right atrium, reducing the risk of it traveling to the lungs.
When flushing a central venous access device (CVAD), what is the appropriate technique for the nurse to use to ensure catheter patency?
A) Use a syringe smaller than 10 mL to create more pressure
B) Use a push-pause method with a 10 mL or larger syringe
C) Use a continuous, steady flush with a 5 mL syringe
D) Flush the CVAD quickly to minimize the time the line is accessed
Correct Answer: B) Use a push-pause method with a 10 mL or larger syringe
Rationale: The push-pause method creates turbulence within the catheter, which helps prevent occlusion. A syringe of 10 mL or larger is used to avoid excessive pressure that could damage the catheter.
A nurse is preparing to withdraw blood from a patient’s central venous access device (CVAD). Which of the following steps should the nurse take first?
A) Flush the line with normal saline before drawing blood
B) Discard the first 5-10 mL of blood withdrawn
C) Apply a hemostatic valve to the CVAD port
D) Use the smallest possible syringe to draw blood to minimize pressure
Correct Answer: B) Discard the first 5-10 mL of blood withdrawn
Rationale: The first 5-10 mL of blood should be discarded to remove any heparin or saline used to flush the catheter, which could dilute the blood sample.
A nurse is preparing to remove a non-tunneled central venous access device (CVAD). What instruction should the nurse give the patient during the removal process?
A) Take a deep breath and hold it
B) Cough forcefully as the catheter is removed
C) Breathe normally throughout the procedure
D) Inhale deeply and slowly exhale during removal
Correct Answer: A) Take a deep breath and hold it
Rationale: Instructing the patient to take a deep breath and hold it increases intrathoracic pressure, reducing the risk of air embolism during CVAD removal.
