Anatomy
Where the tip of a central venous catheter is located.
What is the superior vena cava?
Needs to happen before the line can be accessed for the first time
Location verified by a chest X-ray
Pain, erythema, blanching, induration, fluid leak, purulent drainage
What are reasons to change the site of a VAD?
Edema around site; skin cool to touch; skin discolouration, blanching, or bruising; pain
What are the S&S of infiltration?
Use this solution to swab the port before accessing
What is alcohol?
Inserted in the periphery in the cephalic, basilic or median cubital vein
What is a PICC line?
Used to flush a saline locked, non-valved PICC
What is 10mL of saline and 3mL of heparin 100units/mL?
A CVAD should be flushed with this much saline after blood draws, transfusions, or parenteral nutrition
What is 20mL of saline?
One of the most common complications of CVC insertion (1-1.5% incidence in insertion of hemodialysis catheters)
Hemothorax or Pneumothorax
This much blood is discarded when drawing from a CVAD
What is 4-5mL, none with blood cultures?
Functions to prevent migration of microbes and to hold CVAD in place
What is the Dacron cuff?
How far a PICC line comes out for it to be reportable.
What is 2cm?
Non-coring Huber needles to access and IVAD are changed this frequently
What is Q7Days?
Sluggish flow of IV fluids, inability to aspirate blood
What are the signs of a partial occlusion?
How long to turn off all infusions before accessing a CVAD to draw blood
What is 2 minutes?
Least preferable site for PICC insertion due to the angle of the vein.
What is the cephalic vein
Blood, exudate, moisture, lifting, for troubleshooting
What are the indications to change a CVAD dressing?
How often the dressing on a CVAD should be changed
What is Q7D and prn?
an increase in the fibrous elements in tissue commonly associated with inflammation and marked by loss of elasticity and pliability; sclerosis; a hardened mass or formation.
What is induration?
Can you administer incompatible medications at the same time through a multi-lumen CVAD?
Yes
Phlebitis is more likely seen with these types of catheters (2)
What are PICCs and midline catheters
Routine precautions to prevent complications (5)
Assess site every shift and PRN
Aseptic technique during care and maintenance
Monitor vitals, resp rate and temp especially
Monitor lab results
Assess daily need
What is up to 3 years
a condition marked by a contracted pupil, drooping upper eyelid, and local inability to sweat on one side of the face, caused by damage to sympathetic nerves on that side of the neck.
What is Horner's syndrome?
Always change the needless cap or just take it off before doing this
What is drawing a blood culture from a CVAD?