Vascular Access Procedures Quiz
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Questions and Answers

What indicates a positive Allen's Test when assessing collateral circulation?

  • The skin returns to normal color within 5 seconds
  • The patient cannot make a fist effectively
  • Blushing occurs immediately upon releasing pressure
  • Palmar color does not return to normal after 5-15 seconds (correct)

    • Which of the following is NOT a contraindication for an Aquapheresis catheter?

  • Inappropriate catheter to vein ratio
  • Presence of acute abdomen
  • Accessible Basilic vein in upper arm (correct)
  • Lack of accessible Basilic vein

    • What is the primary use of a pulmonary artery catheter?

  • To administer general blood sampling
  • To monitor arterial blood gas analysis
  • To assess shock and fluid requirements (correct)
  • To perform fluid resuscitation only

    • Which procedure is essential to determine the appropriateness of puncturing the radial artery?

    <p>Modified Allen's Test with ultrasound</p> Signup and view all the answers

    What is the function of a pediatric umbilical catheter?

    <p>Fluid and medication administration</p> Signup and view all the answers

    What must be considered during the insertion of an arterial catheter regarding site selection?

    <p>Multiple possible sites such as femoral and dorsalis pedis</p> Signup and view all the answers

    Which of the following best describes a contraindication for inserting a pulmonary artery catheter?

    <p>Mitral stenosis</p> Signup and view all the answers

    What is one of the indications for monitoring with an arterial catheter?

    <p>Monitoring arterial pressure</p> Signup and view all the answers

    What result from the Allen's Test indicates that the radial artery should not be punctured?

    <p>Color does not return to normal within 5-15 seconds</p> Signup and view all the answers

    Which supply is NOT typically required for the insertion of an arterial catheter?

    <p>Doppler ultrasound machine</p> Signup and view all the answers

    When selecting a site for catheter insertion, which of the following sites is NOT appropriate?

    <p>Subclavian artery</p> Signup and view all the answers

    What should be done prior to performing an arterial catheter insertion?

    <p>Perform an ultrasound of the vein</p> Signup and view all the answers

    Which action is discouraged when accessing vasculature for arterial catheter insertion?

    <p>Making blind-stick attempts</p> Signup and view all the answers

    What is the primary purpose of using a pulmonary artery catheter?

    <p>To monitor cardiac function and hemodynamics</p> Signup and view all the answers

    Which site is preferred for the insertion of a pulmonary artery catheter?

    <p>Right axillary/subclavian vein</p> Signup and view all the answers

    What is a common complication associated with pulmonary artery catheterization?

    <p>Dysrhythmias</p> Signup and view all the answers

    What key equipment is necessary for the insertion of a pulmonary artery catheter?

    <p>Transducing equipment and a wedge syringe</p> Signup and view all the answers

    Which condition is an absolute contraindication for the use of a pulmonary artery catheter?

    <p>Mitral stenosis</p> Signup and view all the answers

    What is the purpose of the introducer sheath used during pulmonary artery catheter insertion?

    <p>To provide a pathway for catheter entry into the vein</p> Signup and view all the answers

    What is the main function of an Aquapheresis catheter?

    <p>To remove excess salt and water from the bloodstream</p> Signup and view all the answers

    What method should be avoided when inserting a pulmonary artery catheter?

    <p>Performing blind-sticks to access veins</p> Signup and view all the answers

    What complication is associated with the use of a pulmonary artery catheter?

    <p>Dysrhythmias due to catheter placement</p> Signup and view all the answers

    Which of the following supplies is NOT required for the insertion of a pulmonary artery catheter?

    <p>Hemodialysis catheter</p> Signup and view all the answers

    What is a critical aspect of the cardiac monitoring during the insertion of a pulmonary artery catheter?

    <p>Interpreting hemodynamic waveforms</p> Signup and view all the answers

    What is a primary advantage of using an Aquapheresis catheter for ultrafiltration therapy?

    <p>It effectively removes excess salt and water</p> Signup and view all the answers

    What is a contraindication to inserting a pulmonary artery catheter?

    <p>Mitral stenosis</p> Signup and view all the answers

    During the procedure for insertion of a pulmonary artery catheter, what technique is strongly advised against?

    <p>Performing 'blind-sticks' for vein access</p> Signup and view all the answers

    What site is preferred for the insertion of the pulmonary artery catheter?

    <p>Right axillary or SC vein</p> Signup and view all the answers

    What typical feature of an Aquapheresis catheter facilitates its purpose?

    <p>Dual lumen design for fluid management</p> Signup and view all the answers

    Which of the following is a contraindication for inserting an arterial catheter into the radial artery?

    <p>Inadequate collateral circulation determining a positive Allen's Test</p> Signup and view all the answers

    Which site is NOT typically selected for arterial catheter insertion?

    <p>Subclavian artery</p> Signup and view all the answers

    Before performing an arterial catheter insertion, which procedure is crucial to ensure safe access?

    <p>Conducting a modified Allen's Test</p> Signup and view all the answers

    What is necessary to ensure proper insertion of an arterial catheter in terms of equipment?

    <p>A stabilization device and sterile dressings</p> Signup and view all the answers

    What action should be taken to minimize complications when inserting an arterial catheter?

    <p>Use a doppler ultrasound to visualize the artery before insertion</p> Signup and view all the answers

    Which of the following describes an indication for the use of an arterial catheter?

    <p>Arterial blood gas analysis</p> Signup and view all the answers

    What test is used to assess the adequacy of collateral circulation before puncturing the radial artery?

    <p>Modified Allen's Test</p> Signup and view all the answers

    Which site is commonly considered for arterial catheter insertion?

    <p>Dorsalis pedis artery</p> Signup and view all the answers

    What is the primary purpose of disinfecting the site before arterial catheter insertion?

    <p>To minimize the risk of infection</p> Signup and view all the answers

    Which action should be avoided to ensure safety during arterial catheterization?

    <p>Performing a 'blind-stick' attempt</p> Signup and view all the answers

    What is the primary goal of using a pulmonary artery catheter?

    <p>To evaluate fluid resuscitation effectiveness and monitor cardiac function</p> Signup and view all the answers

    Which factor is critical to ensure when selecting a site for pulmonary artery catheter insertion?

    <p>Maximal sterile barrier precautions must be implemented</p> Signup and view all the answers

    What must be avoided during the insertion procedure of a pulmonary artery catheter?

    <p>Performing blind-sticks to access veins</p> Signup and view all the answers

    Which statement best describes a vital consideration post insertion of a pulmonary artery catheter?

    <p>Knowledge of hemodynamic waveforms is essential for post insertion care</p> Signup and view all the answers

    What is one of the main contraindications for inserting a pulmonary artery catheter?

    <p>Active mitral stenosis</p> Signup and view all the answers

    What characteristic of the Aquapheresis catheter is essential for its function?

    <p>It facilitates ultrafiltration therapy to remove excess fluids</p> Signup and view all the answers

    Which piece of equipment is NOT required during the insertion procedure of a pulmonary artery catheter?

    <p>Blood transfusion apparatus</p> Signup and view all the answers

    In what situation should the pulmonary arterial catheter be particularly monitored?

    <p>During the entire catheter insertion process</p> Signup and view all the answers

    What skin condition should be assessed at the planned insertion site for a CVAD?

    <p>Presence of any skin lesions or scars</p> Signup and view all the answers

    In assessing veins for potential catheter insertion, what characteristic indicates probable thrombosis?

    <p>Non-compressible or partially compressible target veins</p> Signup and view all the answers

    What is a key feature of Chlorhexidine Gluconate (CHG) that contributes to its effectiveness as a skin antiseptic?

    <p>It forms an ionic bond with cells to destroy the cell wall.</p> Signup and view all the answers

    Considerations for site selection of long-term devices should include which of the following factors?

    <p>The impact of the device on the patient's physical activities</p> Signup and view all the answers

    Why should barriers to secure dressing applications be assessed?

    <p>To reduce the risk of infection and dislodgement</p> Signup and view all the answers

    Which characteristic is NOT associated with an ideal skin antiseptic agent?

    <p>Strong irritation response.</p> Signup and view all the answers

    What impact does the presence of organic material have on antiseptic solutions?

    <p>It can decrease the effectiveness of the antiseptic solution.</p> Signup and view all the answers

    Which medical devices should be checked in the area of the projected vessel before CVAD insertion?

    <p>All implanted devices within the projected vessel area</p> Signup and view all the answers

    How long should Chlorhexidine Gluconate (CHG) be applied using friction to achieve effectiveness in the femoral area?

    <p>2 full minutes.</p> Signup and view all the answers

    Which consideration is important for pediatric patients during CVAD procedures?

    <p>Child Life Specialists should be involved in planning and care</p> Signup and view all the answers

    What characteristic of antiseptics is crucial for skin preparation before CVAD insertion?

    <p>They inhibit microorganisms and limit infection risks</p> Signup and view all the answers

    What should be done to visibly soiled areas before applying Chlorhexidine Gluconate?

    <p>Wash with soap and water before application.</p> Signup and view all the answers

    What is a primary indication for the use of an umbilical artery catheter?

    <p>Continuous blood pressure monitoring</p> Signup and view all the answers

    Which factor is NOT likely to affect the effectiveness of an antiseptic solution?

    <p>Color of the antiseptic solution.</p> Signup and view all the answers

    Which approach can be considered for patients at high risk of accidental catheter dislodgement?

    <p>Exploring creative securement strategies</p> Signup and view all the answers

    What is the optimal tip location for the umbilical vein catheter?

    <p>Near the junction of the inferior vena cava and right atrium</p> Signup and view all the answers

    What is one reason Chlorhexidine Gluconate can inhibit biofilm formation?

    <p>It establishes a cationic bond with bacteria.</p> Signup and view all the answers

    Which antiseptic agent is preferred for providing persistent antibacterial action on skin?

    <p>Chlorhexidine Gluconate.</p> Signup and view all the answers

    Which method is considered most effective for confirming catheter tip location in a case of a congenital cardiac condition?

    <p>Fluoroscopy</p> Signup and view all the answers

    What is NOT a contraindication for the insertion of an umbilical artery catheter?

    <p>Good stump condition</p> Signup and view all the answers

    Which of the following supplies is essential for both umbilical artery and umbilical vein catheter insertion?

    <p>Antimicrobial dressing</p> Signup and view all the answers

    How can the location of umbilical artery catheter tips be confirmed?

    <p>Ultrasonography or fluoroscopy</p> Signup and view all the answers

    What is the maximum sterile barrier precaution required during vascular access procedures?

    <p>Using a full sterile field with caps, masks, gowns, and gloves</p> Signup and view all the answers

    Which technique aids in identifying catheter tip location by injecting normal saline?

    <p>Ultrasonography</p> Signup and view all the answers

    Which imaging technique is considered particularly helpful for confirming catheter tip location in challenging cases?

    <p>Fluoroscopy</p> Signup and view all the answers

    What is NOT a contraindication for placing an umbilical artery catheter?

    <p>Severe dehydration</p> Signup and view all the answers

    What is the primary use of an umbilical artery catheter?

    <p>Blood sampling and monitoring blood pressure</p> Signup and view all the answers

    Which position is recommended for the tip of a low umbilical artery catheter?

    <p>Below the renal arteries and above the aortic bifurcation</p> Signup and view all the answers

    What equipment is essential for the insertion of an umbilical artery catheter?

    <p>Umbilical artery catheter and sterile tray with barrier components</p> Signup and view all the answers

    Which of the following does NOT compare favorably to radiography for confirming catheter tip location?

    <p>Physical examination</p> Signup and view all the answers

    What is the role of saline injection during tip location confirmation?

    <p>To enhance imaging clarity during echocardiography</p> Signup and view all the answers

    Which of the following conditions is an indication for using an umbilical artery catheter?

    <p>Continuous blood pressure monitoring</p> Signup and view all the answers

    Which procedure should be emphasized as part of the pre-insertion assessment for vascular access devices?

    <p>Physical exam of the site</p> Signup and view all the answers

    What indicates the presence of thrombosis when assessing veins for catheter insertion?

    <p>Non-compressible or partially compressible veins</p> Signup and view all the answers

    Which of the following factors should be considered for site selection of a tunneled venous catheter?

    <p>Barriers to secure dressing application</p> Signup and view all the answers

    Involving which professional is crucial during the planning of catheter insertion for pediatric patients?

    <p>Child Life Specialists</p> Signup and view all the answers

    What should be avoided when selecting veins for catheter advancement?

    <p>Using non-compressible veins</p> Signup and view all the answers

    What role does the assessment of skin condition play in the planned insertion site?

    <p>It identifies lesions or conditions that may affect catheter placement</p> Signup and view all the answers

    What aspect of a patient's activities should be assessed when selecting a CVAD site?

    <p>The patient's daily routines and occupations</p> Signup and view all the answers

    Which of the following is not a consideration when assessing for medical devices in the planned vessel area?

    <p>Patient’s weight and BMI</p> Signup and view all the answers

    What is a key characteristic of an effective antiseptic used in skin preparation?

    <p>It inhibits microorganisms on the skin</p> Signup and view all the answers

    What patient-related factor can influence the risk of accidental catheter dislodgement?

    <p>The location of the planned insertion site</p> Signup and view all the answers

    What is an important step to take before device insertion to ensure proper skin preparation?

    <p>Using a chemical agent that limits infections</p> Signup and view all the answers

    What is the primary reason Chlorhexidine Gluconate is preferred as a skin antiseptic according to various organizations?

    <p>It has a broad spectrum of activity and can bond with skin.</p> Signup and view all the answers

    Which property is NOT ideal for skin antiseptic agents?

    <p>High systemic absorption into the bloodstream</p> Signup and view all the answers

    What effect does soap have on Chlorhexidine Gluconate when used as a disinfectant?

    <p>Inactivates its antibacterial properties</p> Signup and view all the answers

    Which factor does NOT influence the activity and effectiveness of an antiseptic solution?

    <p>The humidity of the environment</p> Signup and view all the answers

    What is the recommended application technique for Chlorhexidine Gluconate to ensure effectiveness?

    <p>Use back-and-forth motion for a minimum of 30 seconds.</p> Signup and view all the answers

    Which component is critical to the bactericidal action of Chlorhexidine Gluconate?

    <p>Its ionic bond with cellular structures</p> Signup and view all the answers

    How long should Chlorhexidine Gluconate be applied to the femoral area prior to a procedure?

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

    What property allows Chlorhexidine Gluconate to remain effective in the presence of organic material?

    <p>Binding mechanism with proteins</p> Signup and view all the answers

    What is the main disadvantage of using a skin antiseptic that has high systemic absorption?

    <p>It may cause toxicity in systemic circulation.</p> Signup and view all the answers

    Which of the following is most critical when preparing an insertion site for a catheter?

    <p>Ensuring the skin is clean and free of contaminants</p> Signup and view all the answers

    What is the recommended disinfection level for ultrasound probes used in percutaneous procedures?

    <p>Only low or intermediate level disinfection methods</p> Signup and view all the answers

    Which type of technique is specifically designed to minimize pathogen transmission in medical procedures?

    <p>No Touch Technique</p> Signup and view all the answers

    What is the primary role of the aseptic technique in medical device insertion?

    <p>To minimize the risk of pathogen transmission</p> Signup and view all the answers

    In which setting is it acceptable to insert a Pulmonary Artery Catheter?

    <p>Bedside in critical care settings only</p> Signup and view all the answers

    Which of the following aspects is critical when selecting a site for catheter insertion?

    <p>Assessment of the site for skin conditions</p> Signup and view all the answers

    What must be completed before performing an arterial catheter insertion?

    <p>Obtaining informed consent for any catheter insertion</p> Signup and view all the answers

    During device insertion, which action is explicitly discouraged to ensure safety?

    <p>Touching the infusion items before insertion</p> Signup and view all the answers

    What is vital for effective sterilization of ultrasound probes according to manufacturer guidelines?

    <p>Referencing manufacturer’s instructions for use</p> Signup and view all the answers

    What practice ensures that the areas of the items to be infused remain uncontaminated before insertion?

    <p>Implementation of the No Touch Technique</p> Signup and view all the answers

    Why is it essential to explain the risks, benefits, and alternatives of sedation to patients or their families?

    <p>To fulfill ethical and legal obligations</p> Signup and view all the answers

    What is the recommended duration for applying chlorhexidine on the planned insertion site before vascular access?

    <p>30 seconds</p> Signup and view all the answers

    Which of the following methods is an effective alternative to medication for patient comfort during procedures?

    <p>Virtual reality techniques</p> Signup and view all the answers

    What action should be taken if the insertion site is hairy?

    <p>Clip hair with surgical clippers</p> Signup and view all the answers

    When should adhesive engineered securement devices (ESDs) be replaced according to standard guidelines?

    <p>Every 7 days</p> Signup and view all the answers

    What is the primary goal of performing a time-out before a CVAD insertion?

    <p>To confirm patient identity and procedure details</p> Signup and view all the answers

    What type of dressing is recommended for all CVADs as a prevention strategy against CLABSI?

    <p>Antimicrobial dressing</p> Signup and view all the answers

    In addition to proper hand hygiene, what practice is crucial prior to all patient contacts?

    <p>Carrying out a time-out procedure</p> Signup and view all the answers

    What should be done to ensure skin antisepsis at the planned insertion site?

    <p>Use friction to apply an adequate amount of chlorhexidine</p> Signup and view all the answers

    What is considered a necessary intervention for ensuring the comfort of patients during the insertion of a vascular access device?

    <p>Keeping the patient adequately warm and comfortable</p> Signup and view all the answers

    What is the primary purpose of stability offered by manufactured securement devices?

    <p>To prevent migration and loss of catheter tip position</p> Signup and view all the answers

    What is required for iodine to effectively function as an antiseptic on the skin?

    <p>It must contact the skin for at least two minutes.</p> Signup and view all the answers

    What is the main risk associated with the use of lodophor solutions in neonates?

    <p>Hypothyroidism induction.</p> Signup and view all the answers

    Which property of 70% isopropyl alcohol limits its effectiveness as an antiseptic?

    <p>It lacks residual antimicrobial properties after evaporation.</p> Signup and view all the answers

    What is a consideration when using adhesive removers?

    <p>They can damage the skin if not used carefully.</p> Signup and view all the answers

    Which characteristic is essential for liquid barrier films used as skin protectants?

    <p>They protect skin integrity and should not touch the insertion site directly.</p> Signup and view all the answers

    What is a significant feature of 70% isopropyl alcohol’s method of action?

    <p>It denatures cell proteins and dissolves lipids.</p> Signup and view all the answers

    What is crucial to ensure when applying a skin protectant before securing transparent dressings?

    <p>You must allow it to dry completely before applying any dressing.</p> Signup and view all the answers

    How does the presence of organic matter affect lodophor solutions?

    <p>It neutralizes the iodine, making it ineffective.</p> Signup and view all the answers

    What skin condition makes the use of liquid barrier films particularly beneficial?

    <p>Thin, fragile skin.</p> Signup and view all the answers

    What safety concern is associated with 70% isopropyl alcohol during its application?

    <p>Its flammability poses a risk until it has evaporated.</p> Signup and view all the answers

    What is the primary reason for allowing the skin antiseptic to dry completely before proceeding with a dressing change?

    <p>It prevents a skin reaction and ensures effectiveness.</p> Signup and view all the answers

    What procedure should be performed prior to administering infusates through a CVAD?

    <p>Verify blood return and assess for patency</p> Signup and view all the answers

    What volume of syringe is recommended for assessing CVAD patency?

    <p>10 ml or larger</p> Signup and view all the answers

    Which of the following antiseptics should be used with caution in premature infants and children under 2 months of age?

    <p>Alcoholic chlorhexidine gluconate &gt;0.5%</p> Signup and view all the answers

    What is the recommended time frame for changing TSM dressings when replacing peripheral IVs?

    <p>Every 7 days or when non-adherent</p> Signup and view all the answers

    What should be done if resistance is encountered while flushing a CVAD?

    <p>Check for kinks in the catheter</p> Signup and view all the answers

    Why is it important to assess for allergies before using Heparin as a locking solution?

    <p>Heparin can cause serious allergic reactions</p> Signup and view all the answers

    When documenting a dressing change, which of the following items is NOT essential to include?

    <p>Name of the healthcare provider who performed the change</p> Signup and view all the answers

    Which statement accurately describes the recommended practice for needleless connector changes?

    <p>Change needleless connectors with every dressing change or as required.</p> Signup and view all the answers

    What is the recommended flush solution after administering viscous infusates through a CVAD?

    <p>0.9% sodium chloride</p> Signup and view all the answers

    What type of dressing is recommended to prevent catheter movement and accidental dislodgement?

    <p>Engineered securement device</p> Signup and view all the answers

    Which of the following should NOT be used to flush a CVAD if the infusate is incompatible with sodium chloride?

    <p>0.9% sodium chloride</p> Signup and view all the answers

    In which scenario is it advisable to use larger flushing volumes for CVAD clearance?

    <p>During blood component transfusions</p> Signup and view all the answers

    Which of the following best describes the recommended skin antiseptic for central venous access device (CVAD) dressing changes?

    <p>Alcoholic chlorhexidine gluconate &gt;0.5%</p> Signup and view all the answers

    What is the primary reason for utilizing mechanical interventions when encountering resistance in a CVAD?

    <p>To alter intrathoracic pressure</p> Signup and view all the answers

    What observation at the catheter insertion site may indicate complications that require immediate attention?

    <p>Erythema, swelling, and leakage</p> Signup and view all the answers

    For patients known to have a sensitivity to chlorhexidine, which alternative antiseptic is acceptable?

    <p>1% or 2% tincture of Iodine or iodophors</p> Signup and view all the answers

    Which factor is NOT considered when locking a catheter with Heparin or saline?

    <p>Direction of the catheter insertion</p> Signup and view all the answers

    What should be thoroughly checked if resistance is met while flushing a CVAD?

    <p>Position and components of the catheter</p> Signup and view all the answers

    What is the recommended frequency for assessments of chlorhexidine-impregnated sponges or dressings after application?

    <p>At each dressing change or as prescribed</p> Signup and view all the answers

    What is the recommended dressing change frequency for transparent semipermeable membrane (TSM) dressings?

    <p>At least every 7 days</p> Signup and view all the answers

    Which of the following is NOT a factor that determines the frequency of site assessment for VADs?

    <p>Patient age</p> Signup and view all the answers

    What is a key consideration when using lock solutions in pediatric patients?

    <p>Lower strengths of heparinized saline as per policy</p> Signup and view all the answers

    In case of suspected internal occlusion of a catheter, what should be followed?

    <p>Institutional policy for clearance or replacement</p> Signup and view all the answers

    What should not be considered when assessing for complications related to a VAD?

    <p>Rate of infusion</p> Signup and view all the answers

    What alternative lock solution may be used in patients with recurrent CLABSI?

    <p>Ethanol</p> Signup and view all the answers

    What is the recommendation for changing gauze dressings?

    <p>Every 2 days or when visibly soiled</p> Signup and view all the answers

    Which dressing type allows for direct visualization and moisture release?

    <p>Transparent semipermeable membrane (TSM) dressing</p> Signup and view all the answers

    What is the primary factor influencing the necessity for daily assessment of VADs?

    <p>Institutional policy</p> Signup and view all the answers

    What complication should be specifically watched for with peripheral IV catheters?

    <p>Phlebitis</p> Signup and view all the answers

    What is the appropriate action if a patient's CVAD dressing is found to be loose or wet?

    <p>Call the overseeing facility immediately</p> Signup and view all the answers

    What position should a patient be in for safe removal of a non-tunneled CVAD?

    <p>Lying flat or in a slight Trendelenburg position</p> Signup and view all the answers

    What should be done immediately after removing a catheter to ensure hemostasis?

    <p>Apply continuous pressure at the site to stop bleeding</p> Signup and view all the answers

    Under which circumstance should a CVAD be replaced within 48 hours?

    <p>If aseptic technique cannot be ensured during insertion</p> Signup and view all the answers

    What action should a patient be instructed to perform during catheter removal if they are awake and cooperative?

    <p>Perform the Valsalva maneuver or hum</p> Signup and view all the answers

    What should be done if a patient exhibits signs of phlebitis at the catheter site?

    <p>Remove the catheter immediately</p> Signup and view all the answers

    Which of the following is a crucial step after catheter removal?

    <p>Keep the patient supine for at least 30 minutes</p> Signup and view all the answers

    What is the immediate course of action for a CVAD that shows signs of malfunction?

    <p>Replace the device as soon as possible</p> Signup and view all the answers

    What is the appropriate method to protect the catheter site after removal?

    <p>Use petroleum-based ointment and a sterile occlusive dressing</p> Signup and view all the answers

    What is the appropriate patient position for the removal of tunneled CVADs unless contraindicated?

    <p>Flat or slight Trendelenburg</p> Signup and view all the answers

    Which of the following conditions would indicate the need to replace a peripheral intravenous catheter (PIV) in an adult?

    <p>Insertion in the lower extremities</p> Signup and view all the answers

    What is a key point to consider when removing a midline catheter?

    <p>Removed gently and slowly</p> Signup and view all the answers

    What must be documented after a catheter is removed?

    <p>Catheter site and condition</p> Signup and view all the answers

    When should a caregiver receive education regarding signs and symptoms of complications related to removed devices?

    <p>After the removal process is completed</p> Signup and view all the answers

    Which of the following statements is true about the replacement of peripheral catheters in children?

    <p>Replacement is necessary only if complications arise.</p> Signup and view all the answers

    What is a recommended action before discharge from the infusion center regarding short peripheral catheters?

    <p>Remove short peripheral catheters unless ordered otherwise</p> Signup and view all the answers

    What key aspect should be included in the education provided to patients and caregivers regarding home care for VADs?

    <p>Aseptic technique and flushing protocol</p> Signup and view all the answers

    What should caregivers do if a complication arises from a removed device?

    <p>Seek prompt medical attention</p> Signup and view all the answers

    Which aspect of documentation is crucial when a catheter is removed?

    <p>Any difficulties experienced during removal</p> Signup and view all the answers

    What is the most appropriate position for a patient during the removal of tunneled CVADs?

    <p>Flat (supine) or slight Trendelenburg position</p> Signup and view all the answers

    What should be done if resistance is encountered while removing a catheter?

    <p>Do not pull against resistance and seek assistance</p> Signup and view all the answers

    In which scenario should peripheral intravenous catheters (PIVs) be replaced according to best practice?

    <p>In any site other than the upper extremities as soon as possible</p> Signup and view all the answers

    Which of the following must be documented after catheter removal?

    <p>Catheter length, site condition, and any difficulties</p> Signup and view all the answers

    What is a critical aspect of patient education related to home care for vascular access devices (VADs)?

    <p>Daily site assessment and recognizing complications</p> Signup and view all the answers

    Which of the following is NOT a recommended action following the removal of a non-tunneled CVAD?

    <p>Leaving the site uncovered to air out</p> Signup and view all the answers

    How should peripheral catheters in children be replaced?

    <p>Only when there are clear clinical indications</p> Signup and view all the answers

    What should be included in patient education regarding complications after the removal of a VAD?

    <p>Signs of phlebitis, fever, and drainage should be monitored</p> Signup and view all the answers

    What documentation is crucial when a catheter is removed with noted difficulties?

    <p>Difficulties and any interventions used, along with patient response</p> Signup and view all the answers

    What is a potential complication when performing vascular access procedures on patients with an existing pneumothorax?

    <p>Creation of bilateral pneumothoraces if not positioned properly</p> Signup and view all the answers

    Which symptom might indicate the presence of a pneumothorax during vascular access procedures?

    <p>Sudden cough upon insertion</p> Signup and view all the answers

    Which of the following is an appropriate initial treatment for a small pneumothorax?

    <p>Observation for 24-48 hours</p> Signup and view all the answers

    In the event of an air embolus, which symptom may the patient experience?

    <p>Increased heart rate</p> Signup and view all the answers

    What is a significant risk associated with using ultrasound guidance during central venous access device (CVAD) insertion?

    <p>Potential misinterpretation of vessel anatomy</p> Signup and view all the answers

    What is the best method to determine the extent of a hemothorax following a vascular access procedure?

    <p>Chest radiography or CT imaging</p> Signup and view all the answers

    Which preventative measure should be taken to minimize complications during CVAD insertion?

    <p>Using ultrasound guidance for all inserts</p> Signup and view all the answers

    Which complication is most likely if the introducer or catheter erodes through the vein wall?

    <p>Hemothorax</p> Signup and view all the answers

    What action should be taken if a tension pneumothorax is suspected during a procedure?

    <p>Call for help and prepare for needle decompression</p> Signup and view all the answers

    What characteristic of a hemothorax differentiates it from a pneumothorax?

    <p>Presence of liquid in the pleural space</p> Signup and view all the answers

    What is a significant factor that increases the risk of air embolism during the removal of a CVAD?

    <p>Patient's body positioning</p> Signup and view all the answers

    Which symptom is most indicative of a severe air embolism?

    <p>Dyspnea</p> Signup and view all the answers

    What maneuver can a patient perform to help prevent air entry during CVAD removal?

    <p>Hold their breath</p> Signup and view all the answers

    What is the recommended immediate action if air embolism is suspected during CVAD use?

    <p>Place the patient on their left side in Trendelenburg position</p> Signup and view all the answers

    What is the primary role of using luer lock connections in CVADs?

    <p>To provide a secure connection that minimizes air entry</p> Signup and view all the answers

    What patient condition should ideally be addressed before catheter insertion to prevent complications?

    <p>Hypovolemia</p> Signup and view all the answers

    Which of the following conditions makes a PICC less likely to cause air embolism?

    <p>Longer catheter length and smaller lumen size</p> Signup and view all the answers

    What immediate treatment should be initiated if air is suspected in the catheter during a CVAD procedure?

    <p>Aspirate air from the catheter</p> Signup and view all the answers

    Why is confirming the diagnosis of air embolism challenging?

    <p>Symptoms are often vague and non-specific</p> Signup and view all the answers

    What dressing is recommended to apply immediately after removing a CVAD to minimize risk of air entry?

    <p>Petroleum-based gauze and occlusive dressing</p> Signup and view all the answers

    What is a common cause of a catheter fragment inadvertently becoming an embolus?

    <p>Shearing of catheter or guide wire against resistance</p> Signup and view all the answers

    Which action can help prevent a catheter or wire embolus during removal?

    <p>Removing the needle and guide wire together if resistance is encountered</p> Signup and view all the answers

    What syndrome occurs when a catheter is compressed between the first rib and clavicle?

    <p>Pinch-Off Syndrome</p> Signup and view all the answers

    How can the risk of Pinch-Off Syndrome be minimized during catheter insertion into the subclavian vein?

    <p>Entering laterally through the axillary vein</p> Signup and view all the answers

    What is a crucial step to ensure prior to completing a procedure involving a guidewire?

    <p>Confirming the guidewire is intact and removed</p> Signup and view all the answers

    What type of devices should be used to minimize the risk of complications during pressure injections?

    <p>Pressure injectable devices</p> Signup and view all the answers

    What can happen if resistance is felt while flushing a catheter with a small syringe?

    <p>Catheter may rupture if excessive force is applied</p> Signup and view all the answers

    Which of the following best describes a potential complication of catheterization into the subclavian vein?

    <p>Pneumothorax from needle insertion</p> Signup and view all the answers

    What should be avoided to reduce the risk of catheter breakage during placement?

    <p>Advancing the catheter against resistance</p> Signup and view all the answers

    What factor can contribute to the risk of a guidewire becoming an embolus?

    <p>Improper advancement or redirection of the needle</p> Signup and view all the answers

    What symptoms may indicate a catheter fracture?

    <p>Dyspnea and tachycardia</p> Signup and view all the answers

    What is a potential complication of leaving a catheter fragment in-situ?

    <p>Septic thrombophlebitis and pulmonary embolism</p> Signup and view all the answers

    Which of the following is a treatment option for managing a catheter fragment or embolus?

    <p>Notify licensed independent practitioner</p> Signup and view all the answers

    What should be emphasized in the prevention of catheter-related arrhythmias?

    <p>Maintaining optimal catheter tip position and stabilization</p> Signup and view all the answers

    What could be a reason for choosing left-sided catheter insertion?

    <p>To allow more length before reaching sensitive areas of the heart</p> Signup and view all the answers

    Which symptom is NOT associated with aberrant heart rhythms caused by catheter or wire?

    <p>Dizziness</p> Signup and view all the answers

    What is a critical practice to verify prior to catheter removal?

    <p>Documenting catheter length and inspecting the tip</p> Signup and view all the answers

    What approach can be taken to manage a suspected catheter embolus effectively?

    <p>Apply a tourniquet high in the axilla while restricting venous blood flow</p> Signup and view all the answers

    Which of the following is NOT a symptom of cardiac arrhythmias linked to catheter placement?

    <p>Peripheral edema</p> Signup and view all the answers

    What is the primary purpose of using tip location technology during catheter insertion?

    <p>To ensure the catheter is placed properly and in the correct position</p> Signup and view all the answers

    What is the primary method to confirm successful arterial access before catheter advancement?

    <p>Ultrasound assessment of the needle and/or wire</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with unintended arterial cannulation?

    <p>Reduced blood pressure and faint pulse</p> Signup and view all the answers

    What immediate action should be taken if arterial access cannot be ruled out during catheter insertion?

    <p>Remove the needle or wire and refrain from further dilation</p> Signup and view all the answers

    What is a distinctive characteristic of nerves visualized on ultrasound?

    <p>They have a similar acoustic impedance to soft tissues</p> Signup and view all the answers

    In case of unintended cannulation with a large bore catheter, what is the recommended approach?

    <p>Leave the dilator in place and consult a specialist for removal</p> Signup and view all the answers

    Which of the following factors should NOT be monitored post-cannulation to prevent complications?

    <p>Patient temperature</p> Signup and view all the answers

    What is a potential outcome of nerve injury during CVAD insertion?

    <p>Loss of function in the affected extremity</p> Signup and view all the answers

    Which action is incorrect when identifying possible arterial access complications?

    <p>Assessing for dark, non-pulsatile blood flow</p> Signup and view all the answers

    When might a healthcare provider escalate care immediately following arterial cannulation?

    <p>In the presence of uncontrolled bleeding and distal numbness</p> Signup and view all the answers

    What is a potential consequence of inadequate device securement during an IV insertion?

    <p>Higher risk of vessel trauma leading to phlebitis</p> Signup and view all the answers

    Which of the following is NOT a symptom of phlebitis?

    <p>Fever</p> Signup and view all the answers

    What is a recommended practice to ensure catheter longevity in vascular access?

    <p>Utilize ultrasound for inserting all CVADs</p> Signup and view all the answers

    When treating phlebitis, which action should be taken immediately?

    <p>Stop infusion immediately and do not flush</p> Signup and view all the answers

    Which method is essential in preventing phlebitis related to infusate characteristics?

    <p>Choose VAD type suitable for infusate qualities</p> Signup and view all the answers

    What should be done if extravasation occurs during IV therapy?

    <p>Notify the licensed independent practitioner immediately</p> Signup and view all the answers

    Which of the following conditions can lead to phlebitis due to vessel weakening?

    <p>Use of hyperosmolar infusates</p> Signup and view all the answers

    What is the role of routine site assessment in IV therapy?

    <p>It assists in early detection of complications</p> Signup and view all the answers

    Which statement best reflects the correct management for a patient with phlebitis?

    <p>Monitor the site and avoid pressure application</p> Signup and view all the answers

    What should be done first if there are signs of bacterial phlebitis?

    <p>Remove the catheter immediately.</p> Signup and view all the answers

    Which symptoms indicate the potential presence of venous thrombosis?

    <p>Erythema and palpable cord.</p> Signup and view all the answers

    What is an appropriate action for treating chemical phlebitis?

    <p>Alter the infusion medication or rate.</p> Signup and view all the answers

    Which technique helps in preventing venous thrombosis during catheter insertion?

    <p>Using proper skin preparation and venipuncture techniques.</p> Signup and view all the answers

    What should be reinforced to patients and caregivers regarding potential complications?

    <p>Immediately report any signs of complications.</p> Signup and view all the answers

    What is a key consideration concerning catheter site selection?

    <p>Select an insertion site based on prescribed therapy and vessel size.</p> Signup and view all the answers

    Which care action is for suspected mechanical phlebitis after catheter insertion?

    <p>Elevate the extremity and monitor symptoms.</p> Signup and view all the answers

    What is the primary response required if symptoms of phlebitis continue after initial intervention?

    <p>Remove the catheter.</p> Signup and view all the answers

    Which of the following is a risk factor for developing venous thrombosis?

    <p>Long-term catheter placement without assessment.</p> Signup and view all the answers

    What is essential for proper management and care of a catheter insertion site?

    <p>Follow institutional policy for routine assessments.</p> Signup and view all the answers

    Which of the following is a primary treatment for chemical phlebitis?

    <p>Alter the medication, dilution, or rate of infusion</p> Signup and view all the answers

    What is the primary cause of mechanical phlebitis?

    <p>Excessive movement or manipulation of the cannula</p> Signup and view all the answers

    Which of the following statements best describes a significant risk factor for phlebitis related to chemical causes?

    <p>Injection of solutions that are acidic or alkaline</p> Signup and view all the answers

    What action should be taken immediately upon the first signs of phlebitis?

    <p>Stop the infusion at the first sign of phlebitis</p> Signup and view all the answers

    Which option could contribute to the risk of infectious phlebitis?

    <p>Break in aseptic technique during insertion</p> Signup and view all the answers

    During the treatment of mechanical phlebitis, which method is commonly recommended?

    <p>Applying heat and elevating the extremity</p> Signup and view all the answers

    What type of chemical infusate is most likely to irritate the vein and cause phlebitis?

    <p>Hyperosmolar glucose solution</p> Signup and view all the answers

    Which of the following is NOT a typical symptom of phlebitis?

    <p>Scaly skin at the insertion site</p> Signup and view all the answers

    What characterizes the inflammation associated with phlebitis?

    <p>It is most commonly found in superficial veins</p> Signup and view all the answers

    Which of the following actions is least likely to help alleviate symptoms of mechanical phlebitis?

    <p>Applying a cold pack to the site</p> Signup and view all the answers

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