CVAD Review Questions

CLOSED ENDED CATHETERS

hep lock would NOT be used on these catheters Most hospitals requuire a 20 ml NS FLUSH AFTER BLOOD IS DRAWN.

turn off infusion and *clamp tubing for at least 1-2 mins*

IF CVAD is infusing fluids, _______________before you withdraw specimen.

What medication is used as thrombolytic therapy for an occluded catheter?

*Cathflo Activase (t-PA)*

What is the first action the nurse takes when he/she cannot infuse or aspirate from a CVAD?

*Check for external problems first.*

*After insertion*, what must be done with *all CVADs before use?*

*Chest x-ray*

If a CVP reading is needed on a patient with a non-tunneled CVAD, which lumen is used and why?

*Distal port* due to *largest lumen & closest to heart*

If not in use, how often does an implanted port *need to be flushed* compared to the other CVADs?

*Implanted port*—monthly *(tunneled) Groshong*-weekly *Hickman*- daily *Non-tunneled* -every 8-12 hours *PICC*-depends on protocol for open or closed ended

What is the preventive measure for catheter occlusion?

*Pulsatile flushing*

What is the difference between the VitaCuff and the Dacron cuff on a tunneled catheter?

*Vitacuff*- collagen band on the catheter placed beneath skin to *act as initial barrier to microbes*. *Dacron cuff*- 1-2 inches from exit site- - allows for *tissue ingrowth* and *stabilization of catheter*.

If not in use, how often does an implanted port need to be flushed compared to the other CVADs? *Hickman* - (open)

*daily*

If not in use, how often does an implanted port *need to be flushed*compared to the other CVADs? *PICC-*

*depends on protocol for open or closed ended*

If not in use, how often does an implanted port *need to be flushed* compared to the other CVADs? *Non-tunneled catheter-*

*every 8-12 hours*

What is the #1 complication with CVADs?

*infection*

Where does the *distal tip* reside in the majority of CVADs?

*lower third of the superior vena cava*

If not in use, how often does an implanted port *need to be flushed* compared to the other CVADs? * Groshong(tunneled, close)- *

*weekly*

*Closed ended PICC & Groshong*

Identify the CVAD: *- does not require heparinized saline flushes*

*Non-tunneled catheter*

Identify the CVAD: *- has highest rate of infection*

*PICC*

Identify the CVAD: *- least expensive to insert*

*Broviac*

Identify the CVAD: - first prototype of long-term CVAD used for *pediatric and geriatric patients*

*Non-tunneled catheter*

Identify the CVAD: - usually *not used for long-term use*

*Implanted port*

Identify the CVAD: -needs a *sterile procedure* to even access the port

Why is a *midline catheter* not considered a CVAD?

Distal end *does not end* in superior vena cava.

What is the difference between a power PICC and a regular PICC?

Made of *sturdier material* to take up to *300 psi*. Used for *contrast dyes.*

How do *(+)positive pressure caps*, like the *CLC 2000* *(pressure activated safety valve*) work?

They *prevent reflux* by *returning a small amount fluid to the catheter tip* *after final flush*.

FIRST *ADMINISTER 5 ml of NS* ( with SLOW ROCKING BACK AND FORTH MOTION)- *to gently open up the valve at the distal end* of the catheter

if *withdrawing blood from a closed ended* catheter (without clamps),

SASS method

method used for CLOSED ENDED CATH (no clamps)

SASH- Heparinized saline

method used for OPEN ENDED w/ clamps

If not in use, how often does an implanted port *need to be flushed* compared to the other CVADs? *Implanted port*—

monthly