Exam 1: IV infusion Flashcards
What is the purpose of a VAD
to provide access route for the administration of parenteral fluids and meds
PIV include
short peripheral venous cath
midline cath
Central line include
PICC
CVC
Implant ports
Hemodialysis cath
PIV advantages vs disadvantages
Advantages: easily inserted, low cost, minimal complications, use: short term
Disadvantages: use is limited to fluid/meds, Local tissue injury (infiltration), easily clotted
What catheter gauge is adequate for most therapies including blood
22 gauge
What catheter gauge is indicated for small children and infants
24-26 gauge
What is the preferred side of catheter gauge for surgery
18 gauge
When we assess an IV site what do we look for
redness, swelling, tenderness, blood return, secure site
What is the time for replacement of a PIV
72 to 96 hours
What is the time for replacement of tubing for a PIV
72-96 hours
________ leakage of fluid out of vessel into tissue (not irritating fluid –> no necrosis)
infiltration
__________ leakage of fluid that will cause tissue injury (necrosis –> sloughing)
extravasation
_______ warm, tender, vessel of hart (CORT)
phlebitis
Where does a midline catheter terminate
Peripherally inserted catheter with the tip terminating in proximal portion of upper
extremity at or below the level of the axilla
Generally how long at midlines
3 to 8 inches (double or single lumen)
What vein is usually used for midline insertion
antecubital vein
What are midlines used for
fluid or drug therapy lasting longer than 6 days and up to 14 days
Where does a PICC tip terminate?
tip termination in the superior vena cava near the junction with the right atrium
Is a PICC long term
yes
What is required with PICC placement that isn’t for other access
X ray verification
T/F avoid the use of stop cocks to minimize infection
True
What is the purpose of dressings with VAD
Dressing function to secure the catheter and protect from site contamination
What must we do to maintain dressing integrity
keep dressing clean and dry
Dressing changes: transparent semi-permeable membrane type must be changed __________ but the tape and gauze dressings need to be changed ______
weekly; every 48 hours
CVC-non tunneled: most common vessels
subclavian vein
internal jugular vein
femoral vein
The patient is placed in supine position, site is cleansed (chlorhexidine), skin is anesthetized, a large bore needle is inserted beneath the clavicle. The catheter is advanced over a guidewire. The catheter is sutured–a sterile transparent dressing is applied. What type of CVC is this?
a non tunneled CVC
With a CVC do you need x ray placement confirmation?
yes
X-ray to confirm placement: location in superior vena cava and rule out pneumothorax (air in cavity)
Run isotonic solution at KVO until placement is confirmed
Distal lumen is used to infuse
blood or fluids
Middle lumen is used for
PN
proximal lumen is used for
fluid or infused meds
Which CVC is used for long term use
tunneled
Cuffed catheters inserted surgically, threaded under the skin
Tip of catheter lies in the SVC
What type of CVC is this
tunneled
Which CVC has decreased infection risk
tunneled
Implanted port is used for very long term use–home therapy (over _______)
1 year or longer
with a port what is the placement
Subcutaneous port placed under subcutaneous pocket, requires
accessing–huber needle
interventions for reduction in infection risk with IV
Clean needleless system connections before use with antimicrobial for 30
seconds
Do not tape connections between tubing sets
Use evidence based hand hygiene guidelines from CDC and OSHA
