Quiz 1 Flashcards
List criteria necessary to meet the standard of informed consent.
Explanation of diagnosis and procedure/treatment
Probability of success
Alternatives available for treatment
Assessment of decision maker’s ability to consent
Assurance that consent is voluntary
Why is “true” informed consent difficult in the NICU.
Emotional or physical state of parents
Parents are not legally married so father cannot consent until after birth certificate is done
Physical separation of parents from the infant
Minor parents - considered decision maker but may have lower understanding of situation
Complications of iodine use in neonates
Thin skin - can absorb iodine and negatively impact thyroid (hypothyroidism)
Often dissolved in alcohol so risk for burning the skin
Contraindications to restraints in neonates
May compromise clinical condition
Restraint by assistant is more appropriate
Sedation is preferable
Complications of PAL
Thromboembolism
Infection
Blanching of extremities/loss of digits
The appropriate imaging of confirmation of PICC placement is
AP and lateral radiograph
A common complication of a PICC line is
Infection
A contraindication for PICC placement in a neonate is
Untrained personnel attempting insertion
The appropriate placement of the catheter tip in upper extremity PICC is
At the junction of the SVC and right atrium
Appropriate vessel location of the tip of the UAC in “high” position is
Descending aorta
Complication from a malpositioned UAC include
Vessel perforation
Primary indications for UAC placement include
Need for frequent blood gases
Continuous monitoring of BP
Rescusitation (although UVC is preferred)
Proper vessel placement for a UVC tip is
junction of the inferior vena cava and right atrium
When verifying appropriate placement of a UVC
Catheter tip just above the diaphragm at approximately T8 on xray depicts ideal placement
If the UVC meets obstruction before advancement to the pre-measured insertion goal it may have:
wedged in an intrahepatic branch of the umbilical vein
Aseptic technique does the following:
reduces the risk of infecting patients
True or False: It is important to clean off all antiseptic after it has dried just prior to starting the procedure
FALSE
Techniques to use when there is vasospasm/thrombosis with a PAL
- topical nitroglycerine
- warming of the contralateral limb can produce reflex vasodilation
Of the following, which vessel is the most preferred for PIV?
Cephalic
Greater Saph
Superficial temporal
Cephalic
Risk factors for the development of neonatal thrombosis:
See Table 36.1 (p266)
Oligohydramnios
Sepsis
Emergency C/S
UAV/UVC
IUGR
