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Discuss the 4 types of CVAD's. *Non tunneled catheter - Triple lumen catheter (TLC) *Tunneled catheter - Hickman; Ashcath *Peripherally Inserted Central Catheter (PICC) *Implanted port - Portacath
Describe placement of distal tip of catheter. *IV catheter located in a central VENOUS vessel (internal jugular, subclavian, or femoral vein) *Distal tip of the catheter resting in the superior vena cava just above the right atrium *Xray to check placement prior to using
Identify symptoms of pneumothorax. *S/S: SOB, CP, cough, hypotension, tachycardia, anxiety
What should you do in the event of an air embolism? *Make sure all lumens are closed *Place on left side; head down; Trendelenburg position *Administer 100% O2; continuous O2 Sat monitoring *Page surgeon Stat *Ensure IV access *Draw labs and assist with Xray and ECG
Explain uses of tunneled catheter. *Tunneled catheter is inserted into central vein and remainder is tunneled subcutaneously to a distant exit site *Tunneling helps secure catheter in place and reduces incidence of infection *Dwell time - may remain in place for several months to years
Explain uses of PICC lines? *PICC inserted in upper arm but its tip goes past shoulder and ends in the superior vena cava *Chest xray to confirm proper placement *Stays in place for a year or more
Explain uses of implanted ports. *Totally implanted under skin; more cosmetically appealing *Must use Huber non-coring needle to access them *Long term CVAD
Why is saline flushing of a central line so crucial? *Helps confirm catheter's patency *Avoids drug incompatibilities *Ensures entire drug dose is given *Prevents thrombus formation (10 mL to flush) (every 8 hours in PICC lines)
What are the steps in Blood Sampling Method? *Use 10 mL syringe (w/ 2mL NS) withdraw 5-10 mL of blood and DISCARD *Connect new 10mL syringe and withdraw amount of blood needed for order *Flush catheter w/ 10 mL NS *Close clip
What are the steps in Administering Medication? *Attach 10mL syringe NS *Open clip *Aspirate for blood return (confirms patency) *Saline flush *Administer meds *Saline flush *Maintain positive pressure
Created by: landonmc