Venipuncture: Unit 1 Flashcards
oHow do you avoid irritation and leakage from previous puncture sites?
New IV starts should be made above the earlier site
Do you have to document the amount of times it takes to successfully get into a bank
yes
how long can midline catheters be used for?
2-4 weeks
what is the length of midline catheters
3-8 inches
What are central venous access devices (CVADs) used for?
long-term or home IV therapy
What must be used with ALL CVADs?
IV pump
Where do all CVADs get placed?
(the tip lies in the) inferior or superior vena cava (just above the right atrium)
How do you ensure accurate placement of a CVAD?
radiological confirmation
How long can a peripherally inserted central catheter (PICC) be placed for?
6 months to a year
When a patient has a PICC, where do you take their blood pressure?
on the arm WITHOUT the PICC line
How many lumens can a PICC have?
single or mulitple
Where are non-tunneled catheters usually inserted?
jugular or femoral veins
How long are non-tunneled catheters
6-8 inches
how long can you use non-tunneled catheters
5 to 10 days
how many lumens do non-tunneled catheters have
1-4
How are tunneled catheters inserted
surgery
how long can a tunneled catheter be in place
months to years long
3 common names for tunneled catheters
hickman
broviac
groshong
How long can ports go, when in use, until it needs to be heparinized?
4-6 weeks
What are implanted ports used for
long term and complex iv therapy
What type of needle is used for port access
huber needle
How do you check ALL CVAD placements?
x-ray after insertion
When can CVADs be used, after placed
once confirmed correct placement
How often do you have to assess the site
every 4 hours
what size of syringe do you have to use to flush catheters
10 ml or higher, DUE TO PRESSURE ISSUES
How do you check for patency of catheter
by withdrawing blood prior to giving medication
When flushing a catheter, what method do you use
push pause method
How often do you flush PICC lines, and with how much saline
12 hours/ 10 mL
how much do you flush with, BEFORE and AFTER medication administration? How much do you flush with when obtaining blood?
meds: 10 mL each time NS
Blood: 20 mL NS
when do you flush implanted ports with heparin (100 units/ml, per order)
when locking port or discontinuing port needle.
what are three conditions in which you change a CVAD transparent occlusive dressings
loose
wet
or weekly (usually every monday)
What does SAVE stand for:
S: scrupulous hand hygiene
A: Aseptic technique
V: vigorous friction to hubs
E: ensure patency
when malnutrition occurs what are the major complications patients suffer from
morbidity and mortality due to infection and organ failure
what is TPN and what does it stand for?
total parenteral nutrition: nutrition directly into veins
what do parenteral nutrition solutions provide:
carbohydrates, amino acids, and essential fats
when are parenteral nutrition used: (7 options)
- patients who are unable to take nutrition enterally for more than 7 days
- malabsorption syndromes
- bowel surgery
- coma
- bedrest
- intractable vomiting and diarrhea
- massive wound healing secondary to trauma or major infection
If there is a bag that is not ready when needed for TPN, what do you do?
hang 10% dextrose at the same rate. DO NOT SHUT UP TPN
when a central line is infusing TPN, what is something to remember?
Never shut off a TPN line or a Central Line
What are some signs and symptoms of hyperglycemia
headache, nausea and vomiting, abdominal pain, dizziness, rapid pulse, rapid shallow respirations, fruity breath
what are signs and symptoms of hypoglycemia
nervousness, tremors, headache, sweating, cold clammy skin, and hunger
what are the ONLY TWO nutritional additives that can be administered ivpb or in TPN
insulin and lipids
what are 6 functions of the blood system
- supplying cells with oxygen
- removing waste products from tissues
3.protecting the body - transporting hormones
- promotion of clotting
- regulating body temperature
what is the normal hemoglobin levels range
12- 16 grams
what is the level of hemoglobin that indicates a blood transfusion should happen
7 or 8
how much do you expect the platelet count to increase for each unit of blood infused
5,000 to 10,000
what can blood not be infused with
everything but normal saline
when must a patients signature be obtained when dealing with blood
with consent or refusal
when should you get blood from the lab
once iv site is well established and saline is infused
what needle gauge is required at least for a blood transfusion
what needle gauge is recommended
20
18
when are the four times you check vital signs for blood transfusions
no more than 30 minutes prior to starting
15 minutes of the start of transfusion
after the infusion is complete
3 hours after completion of the infusion
what type of filter do you used when blood administration
inline
how fast should one unit of packed red blood cells be infused
2 to 4 hours, for sure no more than 4
What are 3 things you do if a transfusion of blood reaction occurs
- immediately stop
- attached new prime tubing with NS, obtain vital signs, notify hcp and lab
- obtain lab samples
