Seminar 7 IV meds and PICC lines Flashcards
What are the three additional rights for parenteral med administration
-Right dilution
-Right compatibility
-Right Rate of administration
What is a PICC
a central catheter that is inserted through a peripheral vessel
Where is the tip of a PICC catheter located
Lower portion of the distal superior vena cava
What length of time is a PICC indicated for
treatments expected to last more than one month but less than a year
after a PICC is inserted what test needs to be performed to verify the tip is in the correct place
Chest X-Ray
Would you ever use a CVAD when the tip position has not been confirmed
NO
Do you have to clamp a Valved CVAD
NO since the valve prevents backflow
What are indications for a PICC line
-administering a large amount of fluid quickly
-Administering medications that would be irritating or damaging to peripheral vessels ie extreme pH or hypertonic
what size of syringe do you always use when flushing a PICC
always use a 10 mL or greater syringe since it creates less pressure
when would you lock a line with saline vs heparin
Saline is for short term CVADS heparin is for long term CVADS
How much do you flush a CVAD with before and after med administration
Flush with 10 mL before and 20 mL after
How often does the transparent dressing need to be changed for a PICC line
Changed every 7 days or PRN
how often are the needless caps changed on a PICC line
every 7 days or PRN
how much can the external length of a PICC change before it is an issue
can move 2cm but any more than that it needs to be report it to the IV team
for a continuous infusion when would you remove fluid from the bag before injecting the medication
if the volume of the additive is 10% or more than the total bag volume the equivalent volume must be removed
how often is intermittent IV tubing changed
Changed every 24 hours
how much saline do you use for a pre and post med flush for a PVAD
3-5 mL before and 10 mL after
What is the difference between a tandem and piggy back infusion
tandem is when you need two different meds running at two different rates so will need two pumps with one line connected below both pumps
-piggy back is when one bag is lower than the other so one bag will infuse and then the other one will start when it runs out
what is the benefit of using multi lumen catheters for a PICC
it allows the nurse to administer multiple incompatible medications at the same time
Which lumen would be bigger a 16 g or 18 g
the 16 g would be bigger since gauge is backwards (the smaller number is bigger)
what is bigger a 3 french or 4 french catheter
a 4 french catheter (french sizing is normal where the bigger number is the bigger catheter)
what is often the first sign of a PICC migrating into the right atrium
heart palpitations
How long does a Premixed IV bag have until it is expired
24 hours
how often does continuous infusion tubing need to be changed
every 72-96 hours
after a heparin drip has been started what is the rate always determined by?
a daily PTT
