CVADs

Question 1

Central venous access can be achieved by three different methods:

Answer 1

1) centrally inserted catheters
2) peripherally inserted catheters (PICCs)
3) implanted ports

Question 2

The major disadvantages of CVADs:

Answer 2

1) increased risk of systemic infection

2) invasiveness of the procedure

Question 3

Advantages of CVADs include:

Answer 3

1) reduced need for multiple venipunctures
2) decreased risk of extravasation injury
3) immediate access to the central venous system

Question 4

The type of CVAD inserted into a vein in the neck or chest (subclavian or jugular) or groin (femoral) with the tip resting in the distal end of the superior vena cava.

Answer 4

Centrally inserted catheters aka central venous catheters (CVCs).

Question 5

A type of cuff on a CVC that serves to stabilize the catheter and may decrease the incidence of infection by impeding bacteria migration.

Answer 5

Dacron cuff

Question 6

Accurate placement of a CVC must be verified before use by:

Answer 6

Chest x-ray

Question 7

Care requirements of a CVC are:

Answer 7

1) injection cap change
2) cleansing
3) flushing
4) dressing change

Question 8

Exact frequency and procedures for care requirements of a CVC vary and are outlined in the:

Answer 8

individual institution’s policy

Question 9

Hickman catheter

Answer 9

A specific type of long-term central catheter which requires clamps to make sure the valve is closed.

Question 10

Groshong catheter

Answer 10

A specific type of long-term central catheter which has a valve that opens as fluid is withdrawn or infused and remains closed when not in use.

Question 11

Central venous catheters inserted into a vein in the arm rather than a vein in the neck or chest.

Answer 11

Peripherally inserted central catheters (PICCs).

Question 12

Advantages of a PICC over a CVC:

Answer 12

1) lower infection rate
2) fewer insertion related complications
3) decreased cost
4) insertion at bedside or outpatient area

Question 13

Complications of PICC lines include:

Answer 13

1) catheter occlusion

2) phlebitis- usually appears within 7-10 days following insertion

Question 14

Blood pressure readings or blood drawings should not be used for:

Answer 14

the arm in which a PICC is in place

Question 15

PICC line insertion sites are at or just above the:

Answer 15

antecubital fossa (usually cephalic or basilic vein)

Question 16

PICC lines are advanced to a position with the tip ending:

Answer 16

in the distal one third of the superior vena cava

Question 17

Number of lumens on a CVC?

Answer 17

Single-, double-, triple-, or quad-lumen

Question 18

Number of lumens on a PICC?

Answer 18

Single-, or multiple-lumen

Question 19

CVCs are tunneled or nontunneled?

Answer 19

Either tunneled or nontunneled.

Question 20

PICC lines are tunneled or nontunneled?

Answer 20

Nontunneled

Question 21

These catheters can be up to 60 cm in length with gauges from 24 to 16.

Answer 21

PICCs

Question 22

A type of central venous catheter connected to an implanted, single or double subcutaneous injection port:

Answer 22

Implanted Infusion Port

Question 23

The port of an implanted infusion port consists of a metal sheath with a self-sealing silicone:

Answer 23

septum

Question 24

Drugs are injected through the _______ into the port of an implanted infusion port.

Answer 24

skin

Question 25

The reservoir of an implanted infusion port slowly releases the medicine into the:

Answer 25

bloodstream

Question 26

A special needle used to access an implanted infusion port:

Answer 26

Huber-point needle

Question 27

The deflected tip of a Huber-point needle, prevents damage to the septum that could make the port:

Answer 27

useless

Question 28

A 90-degree angle Huber-point needle is used for:

Answer 28

longer infusions

Question 29

Advantages of an implanted infusion port:

Answer 29

1) long-term therapy
2) low risk of infection
3) cosmetic advantages

Question 30

Implanted ports have been developed that are safe for injection of _______________________ at high pressures and controlled rates.

Answer 30

radiopaque contrast media

Question 31

Care requirements of an implanted infusion port include:

Answer 31

regular flushing

Question 32

Formation of “sludge” may also occur with the port septum. This sludge is an accumulation of:

Answer 32

clotted blood and drug precipitate