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