PN Access Flashcards
What is the key to reducing catheter infections?
prevention
Name a thrombolytic
streptokinase & urokinase
How long is the SVC
7 cm
How to identify a CRBSI (cath related blood stream infection)
isolate same organism, culture cath/periph bld, ratio > 5:1
Superior skin antiseptic
2% chlorhexidine solution
What med decreases phlebitis
heparin
Guidewire changes to CL can
increase infection
Tunneled lines can
decrease infection
What meds do you check prior to placing a CL
ASA, NSAIDS, coumadin and heparin
When do you check coags prior to CL placement
coumadin, heparin, rliver disease
What period of time do you hold coumadin before line placement
2 days then check INR
What period of time do you hold heparin
4-6 hours
Why not use antibiotic ointment
disturb flora—may cause resistent bact/fungi
Decreased manipulation of hub/tubing causes
dec risk of infection
Most IVs are made of this
silicone
Most frequent complication of percutaneous IV placement
malposition
Most common non-infectious complication of long term IVs
cath occlusion-thombosis
Where does the infection come from
migrate from skin to hub from insertion site
What strain majority of cath infections
Gram positive isolates
What strain causes slime
Coag Neg. Staph
MRSA comes from (Staph A)
hand contamination is #1
Contaminated Sol’n may cause these strains
Enterobacter, Acinebacter
High failure rate with ABX
Pseudomonas
What disease seen with recurrent Gram Neg infections of IVs
Short gut sundrome
Cannot aspirate blood but can infuse
Fibrin sleeves
Inability to infuse or aspirate
intralumen thrombus, catheter malposition
Causes intralumenal occlusions
drug/heparin interactions, CPN with inapprop CA/Phos ratio and lipid residue
Hydrocholoric acid treats
occlusions of Ca/Phos precipitates
Ethyl ETOH treats
lipid occlusions
Na Bicarb treats
ABX/heparin occlusions
