IV Placement and Contrast Guidelines
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Questions and Answers

Which veins in the upper extremity are commonly used for IV placement?

  • Saphenous veins and brachial arteries
  • Medial marginal, radial, and ulnar veins
  • Inferior vena cava, jugular, and femoral veins
  • Basilic, cephalic, and metacarpal veins (correct)

What is the reason for assessing bifurcations and valves prior to IV placement?

  • To select the right antiseptic for cleansing
  • To determine the best insertion site (correct)
  • To measure the patient's blood pressure
  • To identify the size of the catheter needed

Which materials are not necessary for the insertion of an IV catheter?

  • Tourniquet
  • Gloves
  • Sutures (correct)
  • Antimicrobial agent to cleanse

In the pediatric population, why is accessing veins in the foot and ankle preferred?

<p>It is less visible to small children, decreasing anxiety (B)</p> Signup and view all the answers

What is the maximum time a tourniquet should be applied?

<p>2 minutes (C)</p> Signup and view all the answers

Which condition is an absolute indication for using IV iodinated contrast?

<p>Cancer work-up or follow-up (C)</p> Signup and view all the answers

What is a common risk associated with the use of iodinated contrast?

<p>Contrast-induced nephropathy (B)</p> Signup and view all the answers

Which of these factors would require premedication before administration of IV contrast?

<p>Iodinated contrast allergy (A)</p> Signup and view all the answers

Which group of patients should not receive oral gastrografin due to a contraindication?

<p>Patients at risk for aspiration (C)</p> Signup and view all the answers

What is the maximum weight limit for standard newer angiography tables?

<p>450 pounds (A)</p> Signup and view all the answers

What should be done regarding blood thinners before a procedure involving IV contrast?

<p>They should be held for an appropriate time (D)</p> Signup and view all the answers

Which of the following is NOT a condition that would require consulting with interventional radiology for access?

<p>Chronic migraines (C)</p> Signup and view all the answers

What is the primary reason that pregnant women are considered contraindicated for certain forms of contrast?

<p>Potential harm to the fetus (B)</p> Signup and view all the answers

What is the primary use of Nylon or Prolene sutures in a surgical context?

<p>For sewing in mesh and vascular anastomoses (D)</p> Signup and view all the answers

Which type of knot is considered super strong and used to close tissues under tension?

<p>Surgeon’s Knot (B)</p> Signup and view all the answers

What could be a complication of using too few throws in a surgical knot?

<p>Weak knot that may unravel (C)</p> Signup and view all the answers

What is a characteristic of a slip knot compared to a square knot?

<p>It allows for easy tightening after placement. (D)</p> Signup and view all the answers

What should be maintained to avoid complications like dehiscence during suturing?

<p>A comfortable working distance of 4-6 inches (D)</p> Signup and view all the answers

When tying surgical knots, why is it important to avoid excessive bulk?

<p>Excessive bulk can lead to ischemia and strangulation of tissue. (C)</p> Signup and view all the answers

What technique is used when only one tail is free during knot tying?

<p>One-handed knot tying method (A)</p> Signup and view all the answers

Which of the following describes a correctly tied square knot?

<p>Knot consists of two throws that cross each other. (B)</p> Signup and view all the answers

What is a common complication of phlebotomy that relates to the immune system?

<p>Latex or adhesive allergy (C)</p> Signup and view all the answers

Which complication is specifically associated with IV catheter insertion?

<p>Local site infection (D)</p> Signup and view all the answers

What is the preferred site for venipuncture due to its prominence and accessibility?

<p>Median cubital vein (D)</p> Signup and view all the answers

Which complication can arise from IV fluid administration in patients with too much fluid intake?

<p>Hypervolemia (B)</p> Signup and view all the answers

What role do one-way valves play in the veins during blood circulation?

<p>Prevent backflow of blood (C)</p> Signup and view all the answers

What is a common sign of dehydration when receiving hypotonic solutions?

<p>Tachycardia (D)</p> Signup and view all the answers

Which condition is a rare systemic complication associated with IV catheter insertion?

<p>Catheter emboli (C)</p> Signup and view all the answers

Which type of knot is considered reliable and strong when crossing over the midline?

<p>Square Knot (C)</p> Signup and view all the answers

Which anatomical area is primarily used for venipuncture due to the presence of superficial veins?

<p>Cubital fossa (A)</p> Signup and view all the answers

In which scenario might prolonged bleeding occur during phlebotomy?

<p>In patients with coagulopathies (C)</p> Signup and view all the answers

Which condition does NOT indicate an increased fluid need?

<p>Dehydration (A)</p> Signup and view all the answers

What is a potential indicator of volume overload in a patient?

<p>Jugular vein distention (A)</p> Signup and view all the answers

What type of suture is designed to break down over time?

<p>Braided suture (D)</p> Signup and view all the answers

Which statement regarding IV site care is correct?

<p>The IV site should be changed every 96 hours. (D)</p> Signup and view all the answers

Which of the following principles apply when performing a venipuncture?

<p>Follow standard precautions. (A)</p> Signup and view all the answers

What might a patient report if they are developing an infection at the IV site?

<p>Increased pain and redness (B)</p> Signup and view all the answers

What is a significant consideration when interpreting imaging exams overnight?

<p>Access may be limited and some exams may not be read overnight. (C)</p> Signup and view all the answers

What challenge is mentioned regarding patient mobility and cooperation during imaging exams?

<p>Long exams can affect patient cooperation. (B)</p> Signup and view all the answers

How does the weight of a patient influence the quality of imaging results?

<p>Increased weight typically leads to a decline in image quality. (C)</p> Signup and view all the answers

What is a primary risk associated with Computed Tomography (CT) scans?

<p>High mortality/morbidity due to radiation exposure. (D)</p> Signup and view all the answers

What is a key requirement for abdominal examinations in patients undergoing MRI?

<p>Patients should be NPO for at least 4 hours. (B)</p> Signup and view all the answers

Which of the following accurately describes access to imaging services?

<p>CT services are typically available any time in most centers. (A)</p> Signup and view all the answers

What precaution is necessary for the use of IV contrast during imaging exams?

<p>IV access must be established to accommodate the injection. (C)</p> Signup and view all the answers

What risk is associated with MRI procedures compared to CT scans?

<p>MRI poses no radiation exposure risk. (A)</p> Signup and view all the answers

Flashcards

Contrast Allergy

An adverse reaction to contrast agents, typically iodinated, requiring premedication.

Contrast-Induced Nephropathy (CIN)

Kidney damage linked to iodinated contrast use, often due to renal impairment.

IV Contrast Indications

Conditions like infections, cancer work-ups, vascular issues, and suspected injuries where IV contrast aids diagnosis.

Pregnant Women (IV Contrast)

Generally considered a contraindication to using intravenous iodinated contrast; however, breastfeeding is not.

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Aspiration Risk (Contrast)

Patients at risk of inhaling contrast material, making oral contrast agents unsuitable.

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Bowel Perforation (Contrast)

Presence of a hole in the intestine, precluding oral contrast agents and potentially needing alternative diagnostics.

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Weight Limit (Angiography)

Standard angiography tables have weight limits to ensure patient safety and equipment integrity during procedures.

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Pre-op Clinical Evaluation

Crucial step in preparing a patient for a procedure involving contrast, assessing overall health status to prevent complications.

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Phlebotomy Complications

Problems that can arise during blood drawing, including allergic reactions, fainting, infections, bruising, and prolonged bleeding in patients with clotting disorders.

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IV Catheter Insertion Complications

Possible problems during IV insertion, including allergic reactions, tissue damage at the insertion site, infections, and potential blood clots.

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IV Fluid Administration Complications

Potential problems when giving fluids through IV, including allergic reactions, fluid imbalances (too much or too little), infections, and adverse effects like sepsis.

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Cubital Fossa

Triangular area of the elbow used for venipuncture due to easily accessible and prominent veins.

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Venipuncture Sites

Various locations, including metacarpal veins, cephalic veins, basilic veins, and saphenous veins, which can be used for drawing blood samples.

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IV Insertion Preferred Area

The forearm is the preferred area for IV insertion, promoting comfort and easy access, avoiding the wrist.

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Vein Anatomy

Veins are blood vessels that carry blood back to the heart. The direction of blood flow is controlled by valves, and the movement of blood is facilitated by muscle contractions within the vessel walls.

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Preferred Venipuncture Vein

The median cubital vein is generally the preferred vein for venipuncture in the elbow area.

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IV Placement Sites

The best places for inserting an IV, considering factors like vein health and patient condition.

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IV Materials

Essential items needed to safely insert and maintain an IV line.

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Post-IV Care

Important actions to take after an IV line is established to prevent complications.

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Venipuncture

The technique of drawing blood from a vein.

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Upper Extremity Veins

Metacarpal, basilic, and cephalic veins are common IV access sites in the upper part of the body.

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IV Fluid Rate

The speed at which intravenous fluids are administered, typically 100 ml/hour to replace oral intake, adjusting for increased needs.

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Volume Overload Signs

Symptoms like cough, shortness of breath, edema, increased heart rate, and abnormal lung sounds, indicating too much fluid in the body.

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Dehydration Signs

Symptoms such as dizziness, headache, confusion, low blood pressure, rapid heart rate, and poor skin elasticity suggest a lack of fluids.

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IV Site Changes

The intravenous site should be changed every 96 hours to reduce the risk of infection.

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Knot Tying Indications

Knot tying is used with sutures and is an alternative to instruments for securing tissues.

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Surgical Knot Types

Different knot types have various strengths and uses, including slip knots, square knots, and surgeons knots.

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Absorbable Sutures

Sutures that dissolve over time.

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Non-Absorbable Sutures

Sutures that remain in the body permanently.

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Surgical Knots

Different types of knots used in surgery to tie sutures, each with varying strengths and properties.

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Square Knot

A surgical knot where the suture tails are crossed over each other, providing a strong and tight closure.

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Slip Knot

A surgical knot that loosens easily, allowing for tightening or adjusting, useful for pliable tissues.

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Surgical Knot Throws

Repeated steps involved in tying a surgical knot, affecting its strength and tightness.

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Surgical Knot Complications

Problems from improperly tied knots, including loosening, strangulation, and potential tissue damage.

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Surgical Knot Strength

The amount of force a surgical knot can withstand without coming undone.

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Surgical Knot Tension

The tightness of a surgical knot, determining the pressure exerted on tissues.

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Two-Handed Knot Tying

Surgical knot-tying method involving two hands, maximizing control and precision.

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Radiologist Availability

Radiologist interpretation of images may not be available overnight or on weekends, but often available 24/7 in acute hospital settings and outpatient for same-day appointments.

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CT Scan Prep

No special prep usually required, but patients may need to be NPO (nothing by mouth) for abdominal exams 4 hours beforehand to reduce bowel gas.

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CT Scan Cost

CT scans are expensive, typically ranging from hundreds to thousands of dollars.

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CT Scan Risk

CT scans expose patients to radiation, potentially increasing mortality/morbidity risks, particularly for children and those with breast/ovary/testis conditions, and IV contrast exposure warrants careful consideration.

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MRI Cost

MRI scans are very expensive, typically in the low thousands of dollars.

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MRI Risk

MRIs do not involve radiation exposure, but contrast agents could pose a low risk.

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CT Weight Limit

CT scans have no official weight limit, but image quality may decline with greater patient weight, as adipose tissue limits visualization of deeper structures.

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MRI Availability

MRI availability is less readily available than CT,and not always 24/7, and complex exams may not be reviewed overnight by radiology staff.

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