CVAD
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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
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| 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
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| Identify symptoms of pneumothorax. | *S/S: SOB, CP, cough, hypotension, tachycardia, anxiety
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| 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
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| 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
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| 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
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| Explain uses of implanted ports. | *Totally implanted under skin; more cosmetically appealing
*Must use Huber non-coring needle to access them
*Long term CVAD
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| 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)
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| 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
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| 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
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