Central Venous Catheters
Total Parenteral Nutrition
Developmental Considerations
Blood Transfusions
High-risk Infusions
100

Prior to using a central line, this must be done to confirm placement.

 chest xray

100

True of false: If a patient's TPN gets behind in administering, the nurse can adjust the rate to catch up

False- TPN can NEVER be adjusted unless a physician writes an order for the rate to be adjusted

100

True or false: restraints are a first choice for infants and children with IVs

False: restraints are ALWAYS a last resort when all other options have been exhausted

100

This culture refuses blood transfusions

Jehovah's Witnesses- can receive autologous transfusions, hematopoietic stimulant medications, and fluids

100

What does a PTT measure? What is a therapeutic PTT?

A PTT measures time to allow for blood clotting. 60-100 (A therapeutic PTT means the blood clotting is properly delayed due to heparin)

200

Describe considerations associated with a peripherally inserted central catheter (PICC)

Can be placed by an RN or physician, used short term (6-8 weeks), common in home care, avoid blood pressure checks in this extremity

200

Peripheral Parenteral Nutrition is administered via _____ with a dextrose content not exceeding _____

1. Peripheral IV, 2. 10%

200

Symptoms of dehydration in infants

Sunken eye sockets, sunken fontanel, weight loss

200

This is the only fluid that can run alongside a blood product

0.9% Sodium Chloride (Normal Saline)
200

What are the symptoms of an elevated PTT?

Delayed clotting-> risk of bleeding/bruising (bleeding gums, abnormal bruising patterns, tarry/dark stools)

300

Arrhythmias or heart tissue damage can occur if this CVC complication occurs

Malposition/migration

300

This is the volume administered in 24 hours when TPN is initiated

1000-2000 mL

300

Symptoms of dehydration in older adults

Thickened saliva, confusion (do not assess skin turgor)

300

Blood must be spiked within _____ of the time it arrived to the unit from the blood bank

30 minutes

300

True or false: heparin can be administered via gravity

False- must be delivered via infusion pump

400

These central line-associated tasks are prohibited in the LPN scope of practice

Access an implanted port, Access a CVC being used for hemodynamic measurement, Administer thrombolytic to declot a CVC (i.e., alteplase), Administer medcations via the umbilical access, Insert, remove, or repair a CVC 

400

The frequency in which blood sugar is checked during a TPN infusion

Q 6-8h

400

Describe how a blood pressure can be used as a tourniquet

Can be used for older adults with fragile veins. Place 6 inches above insertion site. Inflate cuff to 10mmHg, 20mmHg if patient has a fluid deficit

400
List the universal donor and universal recipient bloodtypes

Universal donor: O-, universal recipient: AB+

400

True or false: An LPN can adjust the rate of heparin if the provider changes the order

True- an LPN cannot titrate based on PTT, but can change an infusion rate if the ordered rate changes

500

Describe the process of flushing a CVC

Use a 10mL syringe, scrub the hub for 15 seconds and dry for 5 seconds, connect the syringe, unclamp the line, check blood return and flush using a push pause technique, clamp line, disconnect syringe, connect swabcap

500

Frequency in which TPN flow rate should be checked

Every 4 hours

500

List three anatomical/physical considerations of infants that contribute to an increased risk of dehydration

Infant kidneys absorb less fluid; Higher body surface area than body, likely to lose water through the skin; More subcutaneous fat: hold less water

500

Describe the initial interventions during a blood transfusion reaction

1. Stop the transfusion IMMEDIATELY 2. Begin an infusion of normal saline (with new tubing) at KVO rate 3.Remain with the patient and call for help 4.Notify the provider 5.Oxygen can be administered to patients with SOB 6. Send blood bag, label, and tubing to the blood bank for investigation

500

What is the LPN's role in chemotherapy administration? Where do chemotherapy supplies get disposed?

The LPN cannot administer chemotherapy, but can monitor a patient receiving chemotherapy and dispose of body fluids. All products contaminated with chemotherapy should be disposed in yellow bins.