Week 4 central lines

Question 1

Central Venous access=

Answer 1

surgical puncture of the internal jugular, subclavian, or femoral vein, placed near the heart for long-term use

Question 2

Reasons for having a central line

Answer 2

Long-term med admin/
Vaso-irritating meds
Admin/ of fluids and or nutritional compounds (Hyperalimentation)
TPN= Total Parenteral Nutrition
Transfusion of blood
Multiple blood drawings for diagnostics

Question 3

Pros of central line

Answer 3

Less likely to clot over time
Less pain overall for PT
Access line multiple times

Question 4

Cons of Central line

Answer 4

Cost
Infection
PE/ pneumothorax

Question 5

Different types of central lines:

Answer 5

Peripherally inserted Central Catheter (PICC)
Implanted med/ port
Tunneled venous access device

Question 6

What can you do if you have difficulties in aspirating blood from the PICC line?

Answer 6

If you need blood samples, attach another syringe & aspirate your samples.
– Then attach a new syringe & gently flush the catheter w/ 10mL’s of sterile normal saline.
If the line is patent, attach your IV line to the PICC line and run it at your prescribed flow.

Question 7

1st question to ask PT w/ Tunneled Venous access line

Answer 7

“is the line used for dialysis → if yes DO NOT USE LINE

Question 8

Tunneled Central lines

Answer 8

passed under the skin from the insertion site to a separate exit site.

Question 9

Central venous catheter distal tip location=

Answer 9

above superior vena cava going into right atrium

Question 10

Alimentation=

Answer 10

giving nutrition → TPN Total parenteral nutrition through central catheter

Question 11

Non-tunneled line=

Answer 11

implanted into large vein

Question 12

Central line flushing

Answer 12

Min 10mL but prefer 20mL → b/c able to feel resistance to prefer pushing a thrombus

Question 13

to help aspirate a central line

Answer 13

Twist head, cough, shrug/ roll shoulders,

Question 14

Huber needle for central lines=

Answer 14

bc med ports have rubber septums(tops)

Question 15

Non-coring tip=

Answer 15

hole is slanted on side of needle

Question 16

AICD=

Answer 16

automated internal cardiac defibrillator → left side so doesn’t interfere through pulmonary cardiac vessels

Question 17

Dacron cuff=

Answer 17

lil circle of special tissue sitting under where lumens tunneled (skin)→ prevent infection & m-vt

Question 18

Tunneled devices bc no reflux valve so

Answer 18

CLAMP, CLAMP, CLAMP b/c will suck in air

Question 19

Non-tunneled central line site=

Answer 19

inserted into intra-jugular, very susceptible to infection (in ICUs mostly)

Question 20

When using povidone-iodine swabs to clean a puncture site before you access an implanted venous catheter, you must allow it to dry for at least:

Answer 20

90 seconds