Lab 1 CVAD's Flashcards
Where is the catheter tip located with a CVAD
the lower portion of the distal superior vena cava
How long can a PICC stay in situ for
Up to 1 year but usually only used for 6 months
How long can a non tunneled CVAD stay in for
1 week
how long can a tunneled CVAD stay in for
up to 3 years
how long can a IVAD stay in for
up to 5 years
How often is a PICC drsg changed
every 7 days and PRN
how often is a PICC flushed
every 12 hours
how do you verify the placement of a PICC
chest X-ray
If a patient was going to receive treatment that’s expected to last 2-6 months what type of CVAD might the get
PICC
What is the maximum rate in mL/Sec you can administer through a power PICC
5 mL/sec
What type of treatment are Non tunneled CVAD’s used for
SHort term therapy ie less the one week
What keeps a Tunneled CVAD in place and acts as a barrier to infection
the Dacron cuff
How often is an IVAD flushed
usually every 8 weeks
How could you access if the catheter tip has become dislodged with an IVAD
-neck or ear pain
-palpitations
-patient hears gurgling sounds
What are the two types of tunneled CVADS
Cuffed and non cuffed
what length of treatment would a non cuffed CVAD be used for
used in emergencies of treatments less than 3 months
What length of treatment would a cuffed CVAD be used for
Used for treatments that are going to last longer than 3 months
when is a hemo line used
usually when temporary access is needed for a hemo patient or they are waiting to get a fistula
where is the tip of the catheter located if it is a subclavian or jugular CVAD
the lower third of the superior vena cava
What type of CVADs require heparin locking
non valved ones (ones with clamps)
when routinely flushing a CVAD do you need to flush all lumens
yes always have to flush them all to maintain patency
What is the white port most often used for on a PICC
Often used for TPN
where is a CVAD typically placed for central venous pressure monitoring
subclavian or jugular vein
when do you change needles caps on PICC devices
Every 7 days or when you can not clear all the blood from the caps
How much is a PICC line allowed to move before you need to contact the IV team
If OVER 2 cm in either direction you have to contact the IV team
How often does a PICC need to be routinely flushed
every 24 hours
how much do you flush a picc with before med administration
10 mL
how much do you flush a PICC with after med administration
20 mL
Do you have to flush after a needless cap or tubing change
Yes
How often do you change the IV tubing for PVADs and CVADs
Every 24 hours
what pH range is okay to administer peripherally
anything with a pH of 5-9 is okay to administer peripherally
What is the severity of an air embolism dependant on
Depends on
-Volume of air
-Rate of entry
-Clients position at the time of entry
What volume of air is generally considered significant if it enters the vascular space
anything over 50 mL is generally considered significant
If a patient does get an air embolism what position should they be put in and why?
Trendelenburg left lateral decubitus position (laying on left side head flat feet up) because it traps air in the lower right ventricle
what is the most common cause of a chemical occlusion of a CVAD
Usually related from incompatible medications being mixed and forming a precipitate
What is a mural thrombus
when the thrombus is just attached to the side wall of the catheter which can result in a partial or complete occlusion
what are two signs and symptoms of catheter migration
-Edema of chest or neck during infusion
-Client complains of gurgling sound in ear
can you withdraw blood from a PICC for lab tests
Yes but sometimes it is not as accurate as fresh blood
which lumen is usually the best for a blood draw
usually the biggest lumen (since blood is quite viscous)
if a CVAD is infusing how long do you have to wait after stopping the infusion to draw blood
have to wait at least 2 minutes to get an accurate blood sample
how much fluid do you flush with after a blood draw
20 mL
how much blood must be discarded before sampling collection in general and specifically for in IH
5-10 mL IH policy is 6 mL
When do you change a needless cap on a CVAD
-Every 7 days
-when unable to clear blood from the cap
-if sterility is compromised
What does a StatSeal disk do
used to stop bleeding and keep the site dry
How long is a StatSeal disk left on for
Left on until the first Drsg change (7 Days) then is removed
what should a PICC Drsg be labelled with
-Date
-Time
-Initials of the nurse doing the Drsg
after removing a CVAD how often do you assess for hemorrhage
assess site every 15 min for 1 hour then hourly
after a CVAD removal how often do you have to assess respiratory status
every 15 min for 1 hour
what is one downside of a multi lumen central line
having multiple lumens increases the risk of infection
what is the most important reason to flush a patients central line
to prevent thrombus formation
