Dressings
Central line dressing changes should occur every ___ days or PRN when _______
Dressing changes should occur every 7 days or PRN when dressing becomes soiled or is no longer intact.
How often should TPN/IL infusion sets be changed?
Every 24 hours
Needleless connectors should be changed no more frequently than every ____ days.
Every seven days
Your patient has a 1.9 F PICC line, how much Heparin is needed to lock it?
Trick question! 1.9 F PICC lines cannot be heparin locked and instead require a continuous infusion of 2:1 Heparin to maintain patency.
True or False: When documenting a dressing change in EPIC you should select "new dressing"
False: New dressing implies this is a new central line and this is the first dressing on it. If you are changing an existing dressing at bedside- the correct option is "Changed Dressing"
What information should be written on your IV infusion set labels?
The date & time the set was changed, your initials
List the 4 indications when a needleless connector change for your central venous line is indicated.
1. Before obtaining blood cultures
2. When unable to clear residual blood
3. After completion of blood administration
4. with continuous infusion tubing changes
Your 9 kg patient's port needs to be de-accessed to be discharged home- what concentration and dose of heparin is needed to pack the port?
10u/ml and 50u/5mL
Your patient has a CHG allergy- what should you clean the central line site with during dressing changes?
Iodine or 70% alcohol per policy!
Your patient is on a continuous PCA, how often should the carrier fluid line be changed?
If never disconnected from the patient- every 7 days. If disconnected from the patient at any point (no longer continuous)- every 24 hours.
Changing needleless connectors is a _______& ______ procedure
Sterile & two-nurse procedure
Your patients double-lumen PICC line is due to be Heparin locked- how much heparin do you need to pull?
30u/3mL x2 (one for each lumen)
You admit a patient with an existing PICC line that is dressed.
1. When is the next dressing change due?
2. What should you put on the dressing?
3. In order to use the line- what do you need?
1.Dressing change is due on the seven-day mark unless dressing is no longer clean, dry and intact.
2.Label existing dressing with POA (Present on admission)
3. Xray confirmation of placement and MD to nurse order stating okay to use.
You come onto shift and notice the infusion set that has been delivering continuous IVF is not labeled- what should you do?
Replace unlabeled lines with new labeled lines.
Where are needleless connector changes documented in the patients chart?
LDA Avatar --> Assess ---> Line Care ---> Needleless Connector Change
Your 50 kg patient is due to be de-accessed to be discharged home- how much heparin is needed to pack the port?
500u/5 ml (high dose heparin)
Your patient arrives back to the unit after a PICC line placement- the dressing placed in OR does not have a CHG disk and instead has gauze at the insertion site. When should the dressing be changed?
48 hours post placement.
You come onto shift and find an intermittent med line for your central line looped into itself at the y-site- can you use the infusion set for your antibiotic due in the next hour?
No, a new infusion set is needed.
You notice some residual blood left in the needleless connector after obtaining labs and flushing- what two things should you do?
Change the needleless connector & document it under line care on the LDA avatar.
Needleless connectors should be covered with ___ when not in use.
Alcohol impregnated caps