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68wm6 Vas Acc

Vascular Access and TPN

Three categories of CVADs: *Tunneled CVCs *Percutaneous CVCs *Implanted infusion ports
Where are Percutaneous Central Catheters inserted? *Inserted through the chest wall into the subclavian vein *Inserted through the neck into the internal jugular vein
What is the Alternative for patients requiring long term IV access Peripherally Inserted Central Catheters (PICC)
True or False: PICC poses less risks of complications than CVCs True.
How far does a PICC extend in the body? The PICC extends into the distal third of the superior vena cava
How long is a PICC? 45 to 65 cm in length
How long can a PICC remain in place? 6 months or more
How long can CVCTs remain in place? Several years
What does CVCT stand for? Central Veinous Tunneled Catheter
True or False: PICCs and CVCTs May have several lumens with different ports thus facilitating simultaneous infusions of several solutions True.
Examples of CVCTs Broviac, Groshong, Hickman.
How are CVCTs inserted? Implanted surgically through a subcutaneous tunnel.
Where are implanted vascular access devices normally located? In the client's upper chest.
What kind of needle do you access an implanted vascular access device with? Huber needle .
List 3 Reasons for Implanted Device Placement *Long term IV therapy *Need for frequent venous access *Central venous pressure monitoring (CVP) *Total parenteral nutrition (TPN) *Self administration of treatment *Sclerosed veins *Limited peripheral venous access
What is supposed to be done with un-used lumens prior to accessing a vascular device? They must be flushed(usually Heparin flush 100 units/ml).
How often must un-used lumens in a vascular device be flushed? Every 8 hours (usually Heparin flush 100 units/ml).
When should the dressing over a vascular access device first be changed? within 24 hours.
How often does the dressing over a vascular access device need to be changed after the initial dressing change? Every 7 days.
Caps placed on central lines when not in use should be changed how often? Every 3-7 days
True are False: The client does not need to wear a mask during dressing changes. True. However, if the client is not wearing a mask, they need to have their head turned away or face covered.
Label each lumen or port of the vascular access device tubing with what? A description of its purpose.
True or False: The Practical Nurse/68WM6 can administer medications directly into a veinous access device False.
What is the SASH method in terms of delivering medication in a vascular access device? *SALINE *ADMINISTER *SALINE *HEPARIN
Why is the SASH method used? Many medications are not compatible with heparin
Heparin maintains patency by? Preventing clotting
What is a MAJOR complication of Vascular Access Devices? Air Embolism
What are the signs of symptons of an air embolism? Anxiety and Dyspnea
How do you treat an air embolism? Administer 100% oxygen, position client in left Trendelenburg position and notify physician.
What is a thrombus occlusion? Clot formed at catheter tip related to fibrin build up.
What is a precipitate oclusion? Drugs that interact may cause precipitate that blocks catheter tubing.
What drug is generally used to break up a thrombus occlusion? streptokinase.
List three complications of VADS Infection and sepsis,  Air embolism, Thrombus occlusion, Precipitate occlusion, Mechanical occlusion.
What are mechanical occlusions? *Catheter may have moved out of proper placement. *Opening at catheter tip may be up against wall of vessel.
Created by: Shanejqb