Line Logic
Why might labs be drawn from a CVAD instead of a peripheral stick?
What is to avoid repeated venipuncture, especially in patients/residents with poor veins
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.
Where must TPN be administered-Peripheral or central line?
What is a Central Line?
What is the maximum hang time for a standalone lipid emulsion at room temperature?
What is 12 hours?
What should be confirmed before drawing labs from a CVAD?
What is blood return?
How much blood is typically discarded before collecting samples?
What is 5 ml according to Blessing Hospital Policy
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?
Which in-line filter pore size is required for lipid containing TPN emulsions?
What is 1.2 microns?
True or False: Labs should be drawn from the same lumen used for TPN
False
According to Blessing Hospital Policy, what size syringe is used when drawing and flushing CVADs
What is 10mL syringe
How often should TPN tubing be changed?
What is every 24 hours?
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?
Why should lipid containing TPN be protected from light during infusion?
What is to prevent oxidation and peroxidation of lipides and light sensitive vitamins?
Before drawing labs, what must be turned off and for how long according to Blessing Hospital policy?
What is IV fluids, medication, or TPN/Lipids
What is 5 minutes
Why is it critical to follow policy for waste volume?
What is to ensure sample accuracy and patient safety?
How often should Lipid tubing be changed?
What is every 12 hours?
Where on the IV tubing should the 0.22-micron filter be placed for TPN administration?
What is on the administration set close to the catheter hub...Just before the line enters the patient?
Name 2 clinical or laboratory signs that suggest fat overload syndrome during lipid infusion
What is hypertriglyceridemia (Elevated TG levels) and acute fever
Resource: NIH- "Fat overload syndrome after the rapid infusion of lipid emulsion"
What should you verify in the order before proceeding with a draw?
What is that lab collection from a central line is permitted?
After blood is drawn for testing, flush with how much of this using pulsatile flush.
What is with 20mL normal saline
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 does TPN stand for?
What is Total Parenteral Nutrition?
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