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N242 > Part A: Peripheral Vascular Access Device Indications & Assessment > Flashcards

Part A: Peripheral Vascular Access Device Indications & Assessment Flashcards

1
Q

steps in flushing a PVAD

A
  • Equipment: Sterile saline syringe, alcohol swab
  • Scrub top of site for 15 seconds, let it dry
  • Get air bubbles out of syringe
  • Inject (3-5mL), push pause (turbulent blood flow)
  • At the last 0.5mL close camp shut while injecting last of saline solution to put positive pressure in
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2
Q

complications of PVADs?

A
  • tourniquet retention
  • tubing and catheter misconnections
  • phlebitis
  • air embolism of device fragments
  • inadvertent and thrombosis
  • PVAD infiltration and extravasation
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3
Q

whats the first step in minimizing complications?

A

selection of appropriate device and insertion site

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4
Q

what is most common symptoms with short peripheral catheters (SPC)?

A

phlebitis

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5
Q

what is the FATAL amount of air thats needed for an embolism?

A

50mL max is fatal!! 20mL can be lethal if delivered rapidly

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6
Q

what can happen if theres an unintentional discharge of a PVAD?

A

increase a patient’s risk for phlebitis, bleeding, thrombosis, or infection

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7
Q

what is the purpose of IV therapy ?

A
  • Provide parenteral nutrition
  • Transfuse blood products
  • Provide a route for hemodynamic monitoring and a route for diagnostic testing
  • Administer fluids and medications
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8
Q

what are the two types of VAD’s

A
  • PVAD’s

- CVAD’s

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9
Q

what are the types of PVAD’s?

A

short peripheral and midline

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10
Q

what are the types of CVAD’s?

A

tunnelled, non-tunnelled, PICC, implanted port

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11
Q

what is the location of VAD’s based on?

A

where the tip of the device resides

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12
Q

what do you need to consider when selecting the appropriate VAD?

A 
• Prescribed therapy
• Length of treatment
• Duration the device remains in place
• Vascular characteristics
• Patients age
• Co-morbidities
• History of infusion therapy
• Preference for VAD location
-Resources available to care for the device
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13
Q

what are the three types of osmolarities?

A

isotonic, hypotonic, hypertonic

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14
Q

isotonic solutions

A
  • the same tonicity or osmolarity as blood and other body serums. Stays in intravascular system
  • can cause increased risk for fluid overload in those with renal or cardiac disease
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15
Q

hypotonic solutions

A
  • lower tonicity or osmolarity than blood and other body serums. Shifts from vascular system into interstitial components
  • can exacerbate a hypotensive state
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16
Q

hypertonic solutions

A
  • higher tonicity or osmolarity than blood or other body serums. Shifts from interstitial to vascular system
  • irritating to the vein and can cause increased risk of heart failure and pulmonary edema
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17
Q

to prevent infusion-related complications, what site should you administer solutions with an osmolarity greater than 900mOsm/L?

A

should be infused through a CVAD

18
Q

what site should not be used for vesicant therapy, parenteral nutrition, or infusates with an osmolarity greater than 900mOsm/L?

A

short peripheral catheters

19
Q

what patient teaching should be included with a VAD?

A

• care of the VAD
• Infection prevention
• Potential complications
-Any signs and symptoms to report

20
Q

how often should SPC be assessed?

A

every 4 hours or more if indicated

21
Q

how often should CVADs be assessed and changed?

A

atleast daily and changed every 5-7 days for TSM dressings and atleast every 2 days for gauze dressings

22
Q

what would indicate the need to change a dressing?

A

damp, loosened, and/or visibly soiled

23
Q

what are you assessing the VAD site for?

A

redness, tenderness, swelling, and drainage by visual inspection and palpation through the intact dressing

24
Q

what are expected outcomes of inserting a VAD?

A

-VAD remains patent and site is free from S+S of IV-related complications
• Vital signs are stable
• Fluid and electrolyte
-balance returns to normal
-Patient is able to explain purpose and risks of IV therapy

25
Q

what do you want to know if an IV catheter becomes occluded?

A

occluded catheters should not be flushed because an embolus can form**

26
Q

what are the two methods to IV administration?

A

continuous and intermittent

27
Q

what is continuous IV administration

A

replace or maintain fluid and electrolytes and are also used to administer

28
Q

what are VAD’s?

A

-they are catheters, cannulas, or infusion ports designed for repeated access to vascular system

29
Q

are Central venous catheters (PICCSs), meant for short or long term use?

A

long term use or for admin of medication or solutions that are irritating to veins

30
Q

is a midline catheter (inserted in upper) short or long term use?

A

short term (recommended for 1-4 weeks)

31
Q

IV therapy is used for?

A
  • dehydration
  • burns
  • antibiotics
  • chemotherapy
32
Q

what is turbulent flush?

A

the push pause method

33
Q

what is intermittent IV therapy?

A

site is hooked up and established but IV is not infusing

34
Q

what is continuous IV therapy?

A

site is always infusing

35
Q

at what times do you flush an IV?

A

before administering medications and after administering medications

36
Q

do you flush intermittent IV or continuous?

A

flush only intermittent

37
Q

why do you flush?

A

to maintain patency. patency means its working

38
Q

how much normal saline do you flush with?

A

3-5mL

39
Q

what do you always wanna ensure when flushing an IV

A

that you end on positive pressure (air going in, instead of out)

40
Q

what do you do if you come in and witness patient SOB and their hands feel tight?

A

you’d immediately slow the flow rate and then do a focussed assessment to check other issues

N242 (4 decks)

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