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NRSG 301 > Week 1: CVAD/PICCs > Flashcards

Week 1: CVAD/PICCs Flashcards

1
Q

CVAD indications

A

IV fluid, blood product, medications, irritants, vesicants, pH solutions, hypertonic administration
Obtain venous blood samples
Monitor CVP pressure
Provide pulmonary artery catheters or transvenous pacemaker
Provide hemodialysis access
Consider length of time client needs IV access

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2
Q

Where does a PVAD sit?

A

In the periphery

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3
Q

Where does a CVAD sit?

A

SVC

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4
Q

Where is a PVAD inserted

A

Hand to elbow distal veins of the arm or in the foot

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5
Q

Where is a CVAD inserted?

A

Jugular, cephalic, basilica, brachial, subclavian, femoral

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6
Q

How long is dwell time for a PVAD?

A

Q72-96hrs or PRN

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7
Q

How long is dwell time for a PICC?

A

Up to 1 year (6 months is common)

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8
Q

How long is dwell time for a nontunneled CVAD

A

1 week

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9
Q

How long is dwell time tunneled CVAD

A

up to 3 years

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10
Q

How long is dwell time for an IVAD

A

up to 5 years or # of punctures

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11
Q

What is classified under a CVAD?

A

PICC
nontunneled
tunneled
IVAD

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12
Q

What types of infusions occur with CVAD

A

chemotherapy, long term, TPB, increased osmolality, or decreased pH, higher irritant, cost consideration

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13
Q

What rate of infusion can CVAD take?

A

2-3L/minute

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14
Q

Who can insert a PVAD

A

RN, LPN - some places doctor, anesthetist, IV nurse

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15
Q

Who can insert a PICC?

A

IV nurse

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16
Q

Who can insert CVADs?

A

Surgeon while pt is under anesthetic

17
Q

Can you do blood sampling on a CVAD?

A

Yes - ONLY if needed

18
Q

Can home IV therapy be on a CVAD?

A

Yes - PICC, port a Cath, hemodialysis line

19
Q

PVAD/CVAD Complication risks

A

infection, phlebitis, thrombophlebitis, fluid overload, arterial puncture, hemorrhage, extravasation

20
Q

What are additional CVAD complications

A

catheter embolism, pneumothorax, hemothorax, arrhythmia, Horners syndrome

21
Q

How much does a PVAD cost?

A

under 200 even if multiple attempts

22
Q

How much does a CVAD cost?

A

can be 1500 and more

23
Q

How often is a PVAD dressing changed?

A

PRN, flush per shift if not infusing

24
Q

How often is a CVAD dressing changed?

A

Q7 days and prn

25
Q

How often is a CVAD flushed?

A

Q12 hrs (Q24 with home care)

26
Q

Where is a PICC inserted?

A

in the peripherary in the cephalic, basilica, or median cubital vein above the ACF

27
Q

What does a power injectable do?

A

Allows power injection of contrast media for scans

28
Q

How fast can power injectables infuse

A

5mL/sec (usually all 18 gauge)

29
Q

What are nontunneled lines used for?

A

Short term and emergent therapy

30
Q

What is a Dacron cuff?

A

placed under the skin just above the exit site, granulation tissue grows onto the cuff and creates a seal

31
Q

What does an IVAD consist of?

A

a reservoir, a hollow metal disk with a self sealing membrane, and a catheter

32
Q

What kind of line is a hemo line

A

tunneled central line

33
Q

what do catheters positioned perpendicular to the vein wall have an increased risk for

A

vessel erosion, hydrothorax, hydromediastinum, tamponade, and extravasation

34
Q

Steps before administering medication through a CVAD

A
  1. Check parenteral policy prior to administration
  2. Need to check compatibility of the medication
  3. Check patency of the CVAD
  4. Flush before and after a medication
  5. Flush between medications
35
Q

What is required to administer TPN through a CVAD?

A

An in line filter

36
Q

What is CVP?

A

the pressure measured in the vena cava near the right atrium

37
Q

What are normal CVP ranges

A

3 to 8 cm H2O

NRSG 301 (3 decks)

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