Peripheral and Central Access, Hemodynamic Monitoring Flashcards
Which site is considered optimal for insertion of an intraosseous line?
Proximal tibia
Syringes smaller than ____ mL should not be used for hemodialysis shunts in order to prevent catheter damage from excess infusion pressure.
10
All medications should be flushed with ___ mL of saline to avoid clots.
5
T/F: The non-tunneled catheters are designed for short-term or intermediate-term access.
True
T/F: Peripherally inserted central catheters are designed for intermediate-term to long-term venous access.
True
A power PICC can accommodate pressures up to ____ PSI.
300
Which of the following is TRUE regarding tunneled catheters?
a) They are constructed of a thin-walled silicone
b) They cannot withstand high pressures (such as dialysis)
c) They can be single, double, or triple lumen large bore catheters
d) They are designed for short-term to intermediate-term use
c) They can be single, double, or triple lumen large bore catheters
SVADs require a special injection non-coring needle called:
Huber needle
T/F: If a Huber needle is not available, a 22ga butterfly needle can be used to access a SVAD port.
False
T/F: If a CVAD is infusing sluggishly, it should be vigorously infused with 20-30 mL of normal saline.
True
T/F: Arterial lines provide systolic and diastolic pressure immediately and are more accurate than traditional noninvasive techniques.
True
What artery is easiest to cannulate for an arterial line?
Femoral artery due to its size
Arterial lines should always be labeled in what color to prevent accidental medication administration?
Red
For an arterial line, the ____ mL bag of normal saline should always be pressurized to ____ mmHg to prevent backflow into the cannula and tubing.
500, 300
Arterial lines typically provide ___ga access to adults.
20
T/F: A dampened arterial waveform typically overestimates blood pressure.
False, a dampened arterial waveform typically underestimates blood pressure.
What is typically the reason an arterial waveform is dampened?
Over-pressurization of the pressure bag
The typical arterial line transducer will need to be changed every ____ hours.
96
Which of the following is the most important reason to ensure that the arterial line flush bag does not run dry?
Prevention of an air embolus
T/F: If an arterial line monitor is not producing waveform, you should ensure that all the clamps are open.
True
T/F: If the transducer is placed too low, the readings will be falsely high.
True
T/F: If the arterial line waveform is lost, catheter patency can be checked by attaching a 3cc syringe to the stopcock and withdrawing blood.
True
In the event of accidental dislodgment of an arterial line, pressure should be maintained over the site for a minimum of _____ minutes.
5
What is the most important information obtained from hemodynamic monitoring?
Stroke volume
What color is the proximal lumen that measures central venous pressure?
blue
What sized syringe should be used to inflate the pulmonary artery ballooon?
1.5cc
The pulmonary artery catheter must always maintain a constant flow of ______ in order to maintain patency of the line.
3-5cc/hr
What must the transducer be level with in order to read accurately?
The right atrium
What are the typical indications for leveling of the transducer?
- Upon insertion
- Upon change in the patient’s position
- Just prior to taking a reading
What is the normal range of CVP and RAP?
2 - 6 mmHg
What is a common cause of an elevated CVP and RAP?
Pulmonary Hypertension
T/F: Right ventricular pressure can only be measured during insertion.
True
The pulmonary artery pressure is the pressure within the pulmonary artery when the balloon is ________.
deflated
The pulmonary artery balloon should be inflated for no longer than _____ seconds.
15
T/F: After wedging, the balloon is allowed to passively deflate and return to the right ventricle.
False
What is the normal range for wedge pressures?
4 - 12 mmHg
Which of the following patients would typically have a low cardiac output?
a) patient with hyperthyroidism
b) patient that was just administered vasopressin
c) patient with anemia
d) patient with a heart rate of 168
d) patient with a heart rate of 168
T/F: Right ventricular preload is the same as central venous pressure (2 - 6 mmHg).
True
T/F: The left ventricular preload (LVP) can be indirectly measured by the wedge pressure, and is the same as the left ventricular end diastolic pressure (LVEDP).
True
Your patient has a pulmonary artery catheter inserted. You are now seeing runs of ventricular tachycardia. What should you suspect first?
The right ventricular endocardium is being irritated by the catheter tip.
You note spontaneous wedging. What are acceptable actions to take?
- Try turning the patient on their side
- Aspirate for blood return
- Have the patient raise their arm (nearest to the catheter) above their head and cough
Your patient has a pulmonary artery catheter inserted. What action should be taken if you witness a dampened waveform?
This can be fixed by attempting to pull the catheter back into the right atrium.
