Line Logic
What should you verify in the order before proceeding with a draw?
What is that lab collection from a central line is permitted?
Why do you discard a waste sample when drawing labs from a CVAD?
What is to remove diluted blood or residual flush/medication?
How often should primary IV tubing be changed for continuous infusions?
Primary IV set (If it has stayed connected the entire time) Every 7 days according to Blessing Hospital Policy.
What does TPN stand for?
What is Total Parenteral Nutrition?
Which in-line filter pore size is required for lipid containing TPN emulsions?
What is 1.2 microns?
What should be confirmed before drawing labs from a CVAD?
What is blood return?
After blood is drawn for testing, flush with how much of this using pulsatile flush.
What is with 20mL normal saline
How often should primary IV tubing be changed if it has been disconnected?
What is every 24 hours
What life-threatening metabolic complication can occur if TPN is stopped abruptly?
What is hypoglycemia?
Why should lipid containing TPN be protected from light during infusion?
What is to prevent oxidation and peroxidation of lipides and light sensitive vitamins?
True or False: Labs should be drawn from the same lumen used for TPN
False
Why is it critical to follow policy for waste volume?
What is to ensure sample accuracy and patient safety?
Why is it important to label IV tubing with the date and time of change?
What is to ensure timely maintenance and reduce infection risk?
What is the purpose of the in-line 0.22-micron filter used with TPN?
What is to remove bacteria and particulate matter from non-lipid TPN solutions?
When using the patient/resident own parenteral nutrition, what does the nurse need to do first?
Get the consent form signed
*You can only use the patient/resident PN if the patient/resident signs the consent form
A patient's central venous catheter flushes easily but has no blood return. What are the possible causes of this finding?
Catheter migration, or fibrin sheath formation partial occlusion, Notify the provider if no return persists.
This is a standard step to ensure lab accuracy and patient safety during Central line lab draws
Waste 5 ml blood before drawing the sample
Your patient/resident's TPN set up during morning rounds shows the tubing has been in place for 30 hours. The infusion appears to be clear with no signs of contamination. What should your next action be and why?
Change all tubing immediately
WHY? High risk of central line associated bloodstream infections
A patient/resident is receiving TPN and suddenly develops shortness of breath, chest pain, and a drop in oxygen saturation. What complications might this indicate? What can you do?
This may be an air embolism.
Call a Rapid
administer oxygen
Pause the infusion, place in Trendelenburg on left side and notify provider
A patient/Resident is receiving TPN with lipids piggybacked into the same line. What is the correct setup for the infusion?
Lipids can be Y connected below the TPN filter using a 1.2-micron filter- to prevent fat embolism