Term
| Placement of central lines are what kind of technique? |
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Definition
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Term
| When using the subclavian/ jugular vein for central line placement the patient should be in what position? |
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Definition
| Trendelenburg (head down) |
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Term
| When placing a central line what should be put under the client's shoulder on the proposed side to distend the veins and decrease pneumothorax? |
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Definition
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Term
| Permanent lines are put in place using what kind of anesthesia? |
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Definition
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Term
To confirm placement what should be done? When should it be done? |
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Definition
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Term
What position should the client be in for removal of a temporary central line? |
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Definition
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Term
| While gently removing the catheter, the nurse should have the patient perform what technique? |
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Definition
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Term
| Valsalva's manuever is performed upon catheter removal to prevent what? |
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Definition
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Term
| What kind of dressing is applied to the site after removal? |
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Definition
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Term
| What position should the patient be in for a short period following removal of central line? |
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Definition
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Term
What are the nursing implications following removal of a central line? |
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Definition
Monitor for sigs of complications such as site bleeding. Monitor vital signs. Chart. |
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Term
| Central line site should be sealed within what time frame? |
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Definition
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Term
| How should a culture be done on the catheter tip? |
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Definition
| Clip the tip with sterile scissors and allow the tip to drop into a sterile container. |
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Term
How frequently should a transparent dressing be changed on a central line? Gauze dressing? |
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Definition
72 hours. 48 hours. Change more frequently if dressing b/c unocclusive. |
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Term
What directions should you clean the site when changing the dressing? |
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Definition
center to outer areas in a circular pattern |
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Term
| If you are using Chloraprep to cleanse the site what motion should you use to cleanse the site? |
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Definition
| Back and forth with friction, from center to outer. |
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Term
| Wha should you observe the site for while cleaning? |
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Definition
| erythema, edema, drainage |
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Term
| What should you do before and after dressing changes? |
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Definition
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Term
| You should never use what when changing a dressing? |
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Definition
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Term
| This is a small circular pad that has been impregnated with antimicrobial agents to help provide extra protection from microorganisms: |
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Definition
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Term
| If a central lines becomes disconnected you should do what? |
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Definition
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Term
| Typical change of catheter injection cap is how frequent? |
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Definition
| depends on frequency of use- typical is 3-7 days |
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Term
| Six types of central lines |
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Definition
Triple lumen Subclavian Hickman Implantable ports Peripheral inserted central lines(PICC) Groshong catheter |
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Term
| These two central line forms are temporary, may be placed at the bedside, is placed into the subclavian or jugular and the tip is threaded into the superior vena cava? |
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Definition
Triple lumen subclavian line |
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Term
| Triple lumen and subclavian lines are flushed with___ml of ___ followed by ____ml of ______every _______hours. |
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Definition
5ml of NS 1-2 ml of 100U heparin 8 hours |
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Term
| Triple lumen has how many ports? |
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Definition
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Term
| The three ports are what color and lumen gauge? |
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Definition
White-18 gauge Blue-18 gauge Brown- 16 gauge |
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Term
| What is the longest of the three? |
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Definition
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Term
| What is shortest of the three ports? |
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Definition
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Term
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Definition
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Term
| The subclavian is what kind of lumen? |
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Definition
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Term
| This central line is for long term use (several months to years) and is placed under general anesthesia into the subclavian? |
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Definition
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Term
| This catheter is tunneled underneath the skin in the chest wall with exit just below the nipple line? |
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Definition
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Term
| Exiting heparin should be aspirated with this catheter? |
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Definition
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Term
| The Hickman catheter should be flushed with ____ml of ___ followed by _____ml of _______how frequently? |
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Definition
10ml NS 2-2.5ml 100U heparin once a day (if not in use) |
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Term
| How many lines can a Hickman have? |
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Definition
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Term
| These are placed under the skin surgically under general or local anesthesia? |
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Definition
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Term
| The anatomical placement of a Central implantable port differs from the Hickman how? |
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Definition
| Central Implantable ports are placed just above nipple line |
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Term
These veins are used for peripheral ports? |
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Definition
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Term
Implantable ports are accessed using what kind of technique? |
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Definition
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Term
| What kind of needles are used with implantable ports? |
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Definition
| Huber needles (non-coring) |
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Term
If not in use central implantable ports are flushed how often/ with ____ml of _____ followed by____ml of 100U of_______ |
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Definition
once a month 10ml NS 3-10 ml of heparin |
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Term
Periperal ports not in use are flushed when? with what? followed by? |
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Definition
once a month 2 mL of NS 1 mL of 100U of heparin |
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Term
| These lines are temporary and placed percutaneously through cephalic/ basilic vein by specially trained nurses? |
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Definition
| Peripheral inserted central lines (PICC) |
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Term
| PICC are threaded using a______ via the subclavian into the superior vena cava. |
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Definition
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Term
| Placement must be checked how before use of a PICC line? |
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Definition
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Term
| PICC lines are flushed using ____ml of ____. followed by ____mL of________. how frequent if not in use? |
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Definition
2mL of NS 1mL of 100U heparin 8-12 hours |
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Term
| How many lines can a PICC have? |
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Definition
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Term
| PICC lines can be used how long? |
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Definition
| several weeks to months not exceeding 1 year |
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Term
| This line has a valve at its tip and is made of silicone rubber |
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Definition
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Term
| The valve at the catheter tip is for what purpose? |
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Definition
| to prevent backflow and clotting |
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Term
| How should a Groshong be flushed? |
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Definition
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Term
| What size syringe should be used to flush a central line? |
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Definition
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Term
| NEVER USE THIS SIZE SYRINGE TO FLUSH A LINE |
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Definition
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Term
| The amount of heparinized solution_________ the filling volume of the catheter. |
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Definition
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Term
| after an infusion what should be done to a line? |
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Definition
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Term
| What is meant by use positive pressure when flushing a central line? |
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Definition
| Positive pressure is used to prevent reflux of blood back into the catheter. It is created by closing the clamp while flushing the final mL of solution and keeping your finger on the plunger until the clamp is securely closed |
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Term
What indicated that positive pressure was not maintained? |
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Definition
| Blood backing up in the line |
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Term
| If a line becomes clotted what can the physician use to unclot the line? |
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Definition
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Term
| What is most recognized fibrinolytic |
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Definition
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Term
| This fibrinolytic has many risk factors and side effects? |
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Definition
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Term
| This is known as t-PA and is now being used to unclot catheters? |
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Definition
Alteplase (Activase) or Cathflo Activase |
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Term
| What nursing measure can be taken to help re-establish proper fluid flow? |
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Definition
open closed clamp reposition patient flush cath with NS Have patient raise arm above head on side of cath |
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Term
| Who should do trouble shooting with central lines ? |
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Definition
nurses with experience and extensive IV therapy knowledge and physicians |
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Term
| These intravenous lines are placed into the mid to proximal portion of the upper arm |
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Definition
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Term
| Midline caths are flushed with __mL of NS followed by ___mL 100U heparin every ___hours |
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Definition
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Term
| these caths are placed at the proximal axillary or subclavian vein |
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Definition
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Term
| Utilizd in critical care units to monitor patients blood pressure- inserted by physician |
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Definition
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Term
| Hemodynamic monitoring catheter. Lumens used to attach data monitoring devices to determine cardiac output, core temperature, hemodynamic analysis |
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Definition
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Term
| Temporary and permanent- dressing is same as central line- existing heparin is ALWAYS aspirated first |
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Definition
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Term
hemodialysis caths are flushed with how many mL for a temp line? perm line? |
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Definition
1.3mL 1.5mL of 5000U heparin once daily |
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Term
these are placed in the forearm-connects artery to vein- cannulated and utilized during dialysis |
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Definition
| arteriovenous fistulas (AV) |
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Term
| totally implanted dialysis access system- consists of two titanium and stainless valves with two 12FR cannulae attached. |
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Definition
| implanted ports for dialysis |
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Term
| These are for placed for pain management drug administration via epidural space |
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Definition
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Term
Catheter placed into the bone-fluid and meds administration-usually emergency measure during resuscitation. Used when conventional IV vannot be used. large bore needle inserted into bone marrow of tibia, distal femur |
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Definition
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Term
| IV complications can be recognized by what s/s? |
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Definition
| edema, erythema, drainage, tenderness |
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Term
| Characteristics of infiltration |
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Definition
edema blanched cold no fluid flow by gravity. |
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Term
| Phlebitis characteristics |
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Definition
heat pain redness edema streaking |
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Term
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Definition
same as phlebitis discharge fever/ sepsis site warmth |
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Term
| Air embolism charactistics |
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Definition
decreased BP cyanosis tachycardia jugular vein distention loss of consciousness |
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Term
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Definition
minor: rash, redness, itching major: anaphylaxis |
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Term
|
Definition
pulmonary edema dyspnea cough cyanosis frothy pink sputum jugular vein distention possibly ascites, wt. gain, edema |
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