CVAD, Picc, IV SKILLS Flashcards
peripheral iv needs to be flushed with what size syringe
3-5 mL
why?
the smaller the syringe the greater the PSI
what is the size and length of peripheral iv therapy
Short PIVCs range in length from ¾ inch to 1¼ inch, with gauge sizes from 26 gauge (the smallest) to 14 gauge (large bore)
Peripheral IV: Avoid the use of veins in the lower extremities of adults, if possible, because of an increased risk for deep vein thrombosis (DVT) and infiltration.
peripheral catheters are used for?
short-term use (e.g., fluid restoration after surgery and short-term antibiotic administration).
Central lines are more effective than peripheral catheters for
administering large volumes of fluid, PN, and medications or fluids that irritate veins.
how often should you do a dressing change for a transparent dressing on a CVAD?
every 7 days unless soiled
how often should you do a dressing change for a guaze dressing on a CVAD?
every 48 hours or 2-3 days or when soiled
is inserting CVAD a sterile procedure?
yes, a sterile technique
does piggy back hang higher or lower than primary?
higher
what should you do before you give meds through an iv?
check for patency and swelling, redness, tenderness, warmth, cold, (infiltration or phlebitis)
should you wash your hands before you go gather your equipment?
yes
if it is the first time giving a med to a patient, what should you run the iv infusion on?
the longest time, stay with pt to make sure know side effects and you may also do a test dose like w/ iv iron
how do you decrease risk of air embolism
priming tube, making sure no air bubbles, flushing b4 and after, and trendelenburg when putting in cvad
if you are doing a compatible iv push med with a continuous infusion running, do you flush?
no, only if incompatible.
your iv piggyback connects to the port
closest to the bag
your iv push connects closest to the port
to the pt
when flushing a peripheral iv, what size syringe do you use?
3-5 ml
the smaller the syringe the greater the pressure
when flushing a cvad, what size syring do you use?
10 ml or larger
the larger the syringe the lower the pressure
can you use heparin flush without an order?
no
do you have to wear gloves for ivpb or ivpush?
no, UNLESS only INT line
what are reliable sources for information for iv administration
micromedex
online resources
iv med book
pharmacist
can you give iv meds with blood?
NO! you would need to start a new IV.
blood is only compatible with NS
TPN is only compatible with?
lipids
can you give aminiophyline iv push?
no
Pediatric clients iv should never be gravity. IT SHOULD ALWAYS BE ON A PUMP
Things to know about potassium chloride
–must be diluted
—must be on a PUMP
–NEVER IV PUSH
–can be very painful
–check to be sure adequate urine output….potassium level will go up if oliquria
–never, ever, ever add it to a bag that is already hanging.
—–OPEN A NEW BAG! WE DON’T KNOW DILUTION IF WE ADD TO OTHER BAG
why do we use cvads??
things to know about insulin
–regular insulin is only insulin give iv
–ONLY PUMP if infusion
–D/H x solution == ml/hr
things to know about heparin
–weight based
–med is adjusted by PTT levels
–dose is set per hospital protocols
–always use an infusion pump
–bleeding precautions
–do cluster care and minimize needle sticks to pt to minimize bleeding risk to pt
so you will always use an infusion pump for?
–insulin
–heparin
–potassium chloride
–pediatric meds
what about aminophylline?
answer is 66.7
answer is 11
answer is 8
answer is 5u/100u x 500 ml ==25
do you use the same flush to do pre and post flush?
no, it can be contaminated
can you give heparin and insulin with other meds?
no, but do not stop these if they are continuous. you would need to start a new iv
how often should you check the iv site?
every 2 hours
what size iv for blood
18 q
what size for surgery
18-20 q.
smaller for older adult or peds
what is the last choice of placement for cvad and why?
brachial, more superficial and more infection risk
why can’t tpn go through a regular vein like a peripheral iv?
dextrose is above 20 % and will burn the vein up
what are some reasons we would use cvads?
long term therapy
chemotherapy
tpn
frequent lab work
Make sure you teach them to avoid heavy lifting
what kind of tpn has to be used with midline catheter?
partial
nontunneled
-has wings and is put in in icu
short term use only
Infection rate is higher
tunneled
–no wings and dr must put in in surgery or intervention radiology
–frequent and long term infusions
–has cuff on antibiotic containing material
so remember under the skin is tunneled, can’t see wings, must be put in in surgery and it can be used for long term
can nurses remove any of these?
no
should you shave a patient if they are getting a line?
no, can cause skin irritation and breakdown
*you only clip hair**
make sure curos caps are on ports when not in use
how often should you change ports?
with every dressing change
how long should you apply pressure when removing cvad
15 min
do not flush if
compatible
