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Med surg 2 > Venipuncture: Unit 1 > Flashcards

Venipuncture: Unit 1 Flashcards

1
Q

oHow do you avoid irritation and leakage from previous puncture sites?

A

New IV starts should be made above the earlier site

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2
Q

Do you have to document the amount of times it takes to successfully get into a bank

A

yes

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3
Q

how long can midline catheters be used for?

A

2-4 weeks

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4
Q

what is the length of midline catheters

A

3-8 inches

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5
Q

What are central venous access devices (CVADs) used for?

A

long-term or home IV therapy

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6
Q

What must be used with ALL CVADs?

A

IV pump

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7
Q

Where do all CVADs get placed?

A

(the tip lies in the) inferior or superior vena cava (just above the right atrium)

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8
Q

How do you ensure accurate placement of a CVAD?

A

radiological confirmation

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9
Q

How long can a peripherally inserted central catheter (PICC) be placed for?

A

6 months to a year

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10
Q

When a patient has a PICC, where do you take their blood pressure?

A

on the arm WITHOUT the PICC line

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11
Q

How many lumens can a PICC have?

A

single or mulitple

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12
Q

Where are non-tunneled catheters usually inserted?

A

jugular or femoral veins

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13
Q

How long are non-tunneled catheters

A

6-8 inches

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14
Q

how long can you use non-tunneled catheters

A

5 to 10 days

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15
Q

how many lumens do non-tunneled catheters have

A

1-4

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16
Q

How are tunneled catheters inserted

A

surgery

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17
Q

how long can a tunneled catheter be in place

A

months to years long

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18
Q

3 common names for tunneled catheters

A

hickman
broviac
groshong

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19
Q

How long can ports go, when in use, until it needs to be heparinized?

A

4-6 weeks

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20
Q

What are implanted ports used for

A

long term and complex iv therapy

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21
Q

What type of needle is used for port access

A

huber needle

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22
Q

How do you check ALL CVAD placements?

A

x-ray after insertion

23
Q

When can CVADs be used, after placed

A

once confirmed correct placement

24
Q

How often do you have to assess the site

A

every 4 hours

25
Q

what size of syringe do you have to use to flush catheters

A

10 ml or higher, DUE TO PRESSURE ISSUES

26
Q

How do you check for patency of catheter

A

by withdrawing blood prior to giving medication

27
Q

When flushing a catheter, what method do you use

A

push pause method

28
Q

How often do you flush PICC lines, and with how much saline

A

12 hours/ 10 mL

29
Q

how much do you flush with, BEFORE and AFTER medication administration? How much do you flush with when obtaining blood?

A

meds: 10 mL each time NS
Blood: 20 mL NS

30
Q

when do you flush implanted ports with heparin (100 units/ml, per order)

A

when locking port or discontinuing port needle.

31
Q

what are three conditions in which you change a CVAD transparent occlusive dressings

A

loose
wet
or weekly (usually every monday)

32
Q

What does SAVE stand for:

A

S: scrupulous hand hygiene
A: Aseptic technique
V: vigorous friction to hubs
E: ensure patency

33
Q

when malnutrition occurs what are the major complications patients suffer from

A

morbidity and mortality due to infection and organ failure

34
Q

what is TPN and what does it stand for?

A

total parenteral nutrition: nutrition directly into veins

35
Q

what do parenteral nutrition solutions provide:

A

carbohydrates, amino acids, and essential fats

36
Q

when are parenteral nutrition used: (7 options)

A
  1. patients who are unable to take nutrition enterally for more than 7 days
  2. malabsorption syndromes
  3. bowel surgery
  4. coma
  5. bedrest
  6. intractable vomiting and diarrhea
  7. massive wound healing secondary to trauma or major infection
37
Q

If there is a bag that is not ready when needed for TPN, what do you do?

A

hang 10% dextrose at the same rate. DO NOT SHUT UP TPN

38
Q

when a central line is infusing TPN, what is something to remember?

A

Never shut off a TPN line or a Central Line

39
Q

What are some signs and symptoms of hyperglycemia

A

headache, nausea and vomiting, abdominal pain, dizziness, rapid pulse, rapid shallow respirations, fruity breath

40
Q

what are signs and symptoms of hypoglycemia

A

nervousness, tremors, headache, sweating, cold clammy skin, and hunger

41
Q

what are the ONLY TWO nutritional additives that can be administered ivpb or in TPN

A

insulin and lipids

42
Q

what are 6 functions of the blood system

A
  1. supplying cells with oxygen
  2. removing waste products from tissues
    3.protecting the body
  3. transporting hormones
  4. promotion of clotting
  5. regulating body temperature
43
Q

what is the normal hemoglobin levels range

A

12- 16 grams

44
Q

what is the level of hemoglobin that indicates a blood transfusion should happen

A

7 or 8

45
Q

how much do you expect the platelet count to increase for each unit of blood infused

A

5,000 to 10,000

46
Q

what can blood not be infused with

A

everything but normal saline

47
Q

when must a patients signature be obtained when dealing with blood

A

with consent or refusal

48
Q

when should you get blood from the lab

A

once iv site is well established and saline is infused

49
Q

what needle gauge is required at least for a blood transfusion
what needle gauge is recommended

A

20
18

50
Q

when are the four times you check vital signs for blood transfusions

A

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

51
Q

what type of filter do you used when blood administration

A

inline

52
Q

how fast should one unit of packed red blood cells be infused

A

2 to 4 hours, for sure no more than 4

53
Q

What are 3 things you do if a transfusion of blood reaction occurs

A
  1. immediately stop
  2. attached new prime tubing with NS, obtain vital signs, notify hcp and lab
  3. obtain lab samples

Med surg 2 (6 decks)

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