Podcast
Questions and Answers
In the context of central venous access devices (CVADs), what does the term "peripheral" specifically refer to?
In the context of central venous access devices (CVADs), what does the term "peripheral" specifically refer to?
- The central venous system, including the superior vena cava
- The veins that are easily accessible for venipuncture
- The area of the body close to the heart
- The extremities, such as arms and legs (correct)
Which of the following is NOT a common reason for using a central venous access device (CVAD)?
Which of the following is NOT a common reason for using a central venous access device (CVAD)?
- Delivering chemotherapy drugs for cancer treatment
- Providing nutritional support through parenteral nutrition
- Administering intravenous antibiotics for a long-term infection
- Infusing fluids for hydration in a dehydrated patient (correct)
What is the primary advantage of a tunneled central venous catheter compared to a non-tunneled central venous catheter?
What is the primary advantage of a tunneled central venous catheter compared to a non-tunneled central venous catheter?
- Tunneled catheters are more comfortable for the patient.
- Tunneled catheters allow for the administration of a wider range of medications and solutions.
- Tunneled catheters are easier to insert and require less technical expertise.
- Tunneled catheters have a lower risk of infection due to the subcutaneous tunnel. (correct)
Which type of CVAD is most commonly used for short-term access, often for administering antibiotics or fluids?
Which type of CVAD is most commonly used for short-term access, often for administering antibiotics or fluids?
What is the primary concern associated with the use of central venous access devices (CVADs)?
What is the primary concern associated with the use of central venous access devices (CVADs)?
A patient with limited peripheral venous access would most likely benefit from which type of CVAD?
A patient with limited peripheral venous access would most likely benefit from which type of CVAD?
What is the primary difference between a tunneled central venous catheter and a peripherally inserted central catheter (PICC)?
What is the primary difference between a tunneled central venous catheter and a peripherally inserted central catheter (PICC)?
Which of these is NOT a characteristic of a peripherally inserted central catheter (PICC)?
Which of these is NOT a characteristic of a peripherally inserted central catheter (PICC)?
A patient needing long-term chemotherapy would most likely be fitted with which type of CVAD?
A patient needing long-term chemotherapy would most likely be fitted with which type of CVAD?
What is the main advantage of an implanted infusion port over other types of CVADs?
What is the main advantage of an implanted infusion port over other types of CVADs?
A patient has a tunneled catheter. Which of the following describes the placement of the catheter? Select all that apply.
A patient has a tunneled catheter. Which of the following describes the placement of the catheter? Select all that apply.
What is the common reason for a patient to have an implanted vascular access device, like an implanted infusion port?
What is the common reason for a patient to have an implanted vascular access device, like an implanted infusion port?
A patient has a peripherally inserted central catheter (PICC). What is the maximum recommended duration of PICC use?
A patient has a peripherally inserted central catheter (PICC). What is the maximum recommended duration of PICC use?
Which of the following is NOT a common reason for an implanted vascular access device to be accessed with a Huber-point needle?
Which of the following is NOT a common reason for an implanted vascular access device to be accessed with a Huber-point needle?
Which of the following statements about nontunneled catheters is correct?
Which of the following statements about nontunneled catheters is correct?
A patient with a tunneled catheter complains of swelling and pain around the port. Which of the following actions is MOST appropriate?
A patient with a tunneled catheter complains of swelling and pain around the port. Which of the following actions is MOST appropriate?
What is the primary purpose of the Dacron cuff in a tunneled catheter?
What is the primary purpose of the Dacron cuff in a tunneled catheter?
Which type of catheter is typically used for long-term administration of medications, such as chemotherapy?
Which type of catheter is typically used for long-term administration of medications, such as chemotherapy?
Which of the following is a common nursing intervention for a patient with a PICC line?
Which of the following is a common nursing intervention for a patient with a PICC line?
What is the most accurate method to confirm the placement of a tunneled catheter?
What is the most accurate method to confirm the placement of a tunneled catheter?
Flashcards
Tunneled Catheters
Tunneled Catheters
Catheters designed for long-term use, inserted into veins with a portion tunneled under the skin.
Dacron Cuff
Dacron Cuff
A cuff that stabilizes the tunneled catheter and promotes scar tissue formation.
Nontunneled Catheters
Nontunneled Catheters
Catheters for short-term use, inserted directly into a vein without tunneling.
PICC Line
PICC Line
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Implanted Infusion Ports
Implanted Infusion Ports
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X-ray Verification
X-ray Verification
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Phlebitis
Phlebitis
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Dressing Change for Nontunneled Catheters
Dressing Change for Nontunneled Catheters
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Single vs Multi-lumen Catheter
Single vs Multi-lumen Catheter
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Care Requirements
Care Requirements
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Central Venous Access Devices (CVAD)
Central Venous Access Devices (CVAD)
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Examples of CVAD uses
Examples of CVAD uses
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Advantages of CVAD
Advantages of CVAD
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Disadvantages of CVAD
Disadvantages of CVAD
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Central Line-Associated Bloodstream Infection (CLABSI)
Central Line-Associated Bloodstream Infection (CLABSI)
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Types of CVAD
Types of CVAD
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Peripherally Inserted Central Catheters (PICC)
Peripherally Inserted Central Catheters (PICC)
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Hemodynamic Monitoring
Hemodynamic Monitoring
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Study Notes
Central Venous Access Devices (CVADs)
- CVADs are catheters placed in large veins (subclavian, jugular, or femoral) for frequent, long-term, or specialized vascular access.
- Examples include chemotherapy, antibiotics, hemodialysis, and nutritional support.
Advantages of CVADs
- Immediate access to the central venous system.
- Reduced venipuncture frequency.
- Access for patients with limited peripheral access.
- Hemodynamic monitoring capabilities.
Disadvantages of CVADs
- Increased risk of infection, including central line-associated bloodstream infections (CLABSIs).
Types of CVADs
Centrally Inserted Catheters
- Tunneled or non-tunneled.
- A dacron cuff stabilizes the catheter.
- Used for long-term access.
- The catheter tip is placed in the superior vena cava.
- Lower risk of infection compared to non-tunneled catheters.
- Placement is usually surgical, often in an outpatient setting.
- May be single, double, or quadruple lumen.
Peripherally Inserted Central Catheters (PICCs)
- Typically used for 1 week to 6 or 12 months.
- Inserted into a vein in the arm (usually cephalic or basilic).
- Placed in the lower one-third of the superior vena cava.
- Nontunneled.
- Can be placed in an outpatient setting by trained personnel.
- Redness, swelling, drainage, tenderness or dressing condition should be assessed.
- Phlebitis can occur within 7 to 10 days after insertion.
- The arm with the PICC should not be used for blood pressure measurements or blood draws.
Implanted Infusion Ports
- Long-term use (1 year or more).
- Commonly used for chemotherapy.
- Placement is surgical, into a chest wall pocket.
- The catheter tip is in the superior vena cava.
- Accessed by specially trained personnel with a Huber-point needle.
- Equipped with a self-sealing silicone septum.
- Drugs are injected through the skin into the reservoir then released into the bloodstream.
- Regular flushing is essential.
Tunneled Catheters
- Insertion involves placing part of the catheter in subcutaneous tissue. The Dacron cuff is placed to create separation between the skin and the vein where the catheter enters.
- The subcutaneous tunnel separates the entry point from the vein, reducing the risk of infection.
Nontunneled Catheters
- Used only for short-term use (no more than a few months for typical use).
- The catheter tip rests in the superior vena cava.
- Gauze dressings are changed every 48 hours and transparent dressings every 5-7 days as needed.
- May have single, double, or quad lumens.
Nursing Management of CVADs
- Inspect the catheter and insertion site.
- Assess for pain.
- Change dressings according to facility policy.
- Review injection procedure in the hospital/facility laboratory setting.
- Regular flushing is important.
Removing Central Lines
- Performed according to institution policy.
- Only trained nurses should remove lines.
- Gently withdraw the catheter while the patient performs the Valsalva maneuver.
- Ensure the catheter tip remains intact.
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