CVAD Focus

Question 1

what can you give through CVAD

Answer 1

IV fluids, blood products, meds

Question 2

where does the tip of a CVAD end

Answer 2

in the superior and inferior vena cava

Question 3

what 3 veins can you put a CVAD

Answer 3

internal jugular, subclavian, femoral/brachial

Question 4

what is a port and what are they mostly used for

Answer 4

CVAD under the skin mostly used for chemo

Question 5

what is a fluroscopy

Answer 5

pictures via x ray in real time to see a placement of CVAD

Question 6

what is the only exception for not checking placement on xray is what

Answer 6

fluroscopy

Question 7

what are some reasons somone would need CVAD

Answer 7

parental nutrition, getting stuck lots of times, chemo, irritating vesicants, blood products, to monitor central venous pressure, hemodialysis

Question 8

why would you want to monitor central venous pressure

Answer 8

shows fluid overload

Question 9

how long is a short catheter

Answer 9

1 -1 1/4

Question 10

how long is a short gauge

Answer 10

26 (smallets) - 14 (largest)

Question 11

when should you check a short catheter

Answer 11

per policy but minimum of Q 4 hours

Question 12

how long is a midline

Answer 12

3-8

Question 13

where is a midline placed what is it used for

Answer 13

upper arm - used when needed for hydration, and drug therapy up to 6-14 days

Question 14

where is a PICC placed

Answer 14

basilic (preferred) or cephalic in arm they are LONGG

Question 15

where is the end of a PICC placed

Answer 15

superior vena cava

Question 16

what is the greatest risk for PICC

Answer 16

DVT, and infection

Question 17

what is the gold standard for checking PICC placement

Answer 17

3cg technology uses magnet at then end of catheter

Question 18

who cannot have 3cg technology

Answer 18

someone who doesn’t have normal sinus rhythm

Question 19

what is a non tunneled catheter how long are they used for

Answer 19

go right into the vein, placed in subclavin in upper chest or jugular put into superior vena cava or taken up from femoral artery into inferior vena cava – short term because of high infection rate - 2 weeks

Question 20

what is a tunneled catheter

Answer 20

goes under the skin and a antibiotic cuff is placed to decrease risk of infection so you can use it long term

Question 21

how long can you access a portocath with the same huber needle

Answer 21

7 days

Question 22

what do you need to do after inserting a huber needle

Answer 22

get blood return and flush with 10ml

Question 23

what do you need to do after removing huber needle

Answer 23

lock with heparin lock (per policy) and flush

Question 24

what are some complications for hemodialysis

Answer 24

CLABSI = central line associated blood stream and vein thrombosis

Question 25

what is the largest cath and what are the intervetions for that

Answer 25

hemodialysis so you need to change dressing every 48 hours or every treatment or when soiled

Question 26

what are the common infections for CVAD

Answer 26

staph aureus, yeast and fungi

Question 27

what could happen when disconnection or opening a CVAD

Answer 27

air embolism

Question 28

what kind of technique do you need to do when changing a CVAD dressing and when do you change it

Answer 28

sterile Q 7 days (or per policy )

Question 29

before placement of a cath what do you need to ask your patient

Answer 29

if they have an allergy to chlorhexidine gluconate or latex

Question 30

what kind of CVAD is used for hemodialysis and why

Answer 30

tunneled so the fistula has time to heal it can take 6 months