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19 Cards in this Set

  • Front
  • Back
CVC's have two or more lumens / ports what is each one used for
Distal = incompatible medication, colloids, viscous fluids
Medial= TNP
Proximal= blood sampling, blood admin
how do we prevent blood reflux
maintain positive pressure except for Groshong they have a slit or pressure sensitive valve
Methods to assist in aspirating blood
1. have pt. turn head toward the opposite shoulder
2. raise arm on the same sidwe ad CVC
3 have pat. turn side to side
4 have pt. sit up
5. have pt. cough
6. use the push-pause tech
Air emobolism interventions
1 clamp catheter
2. position in left lateral trendenburg
3. admin 100% o2
4. take vital signs
5. notify md
S/S of air embolism
dyspnea, tachypnea, cough - often with hemptoysis, substernal pain or chest pain when breathing, diaphoriesis, confusion, anxiety, feeling of impending boom, hypotension, decreased breath sounds, pleural friction rub
;removing of the CVC
Valsalva maneurver:
have patient take a deep breath - hold it with mouth closed and bear down or push like having a bowel movement for 10 sections
how is contraindicated for the Valsalva maneuver
increased intracranial pressure, recent eye surgery, myocardial infarcation, experiencing bradycardia or respiratory distress
procedures for removing a non-tunneled central venous line
1 place pt supine or trendenlenburg position
2. remove dressing in aseptic manner
3. remove stiches
4. have pt take a deep breath, hold and bear down
4. pull back on catheter slowly/steadily
5. apply pressure fwith a 4x4 for 15 min. or until homeostasis is acquired
6. inspect central line for intacness
7. instruct pt. to remain supine for 15 min
8. inspect site for 1 hr for bleeding, pain, edema, warmth, redness
9 assess pat for SOB, dyspnea, altered mental status
4 types of central lines
non-tunneled
tunneled
PICC
implanted ports
where is the tip of the CVAD located
superior vena cava = right before the heart
non-tunneled facts
can stay in for a lengthy time
good for emergancies
1 to 4 lumens
has the highest rate for risk for infection
flushed q8hr with 10cc NS when not in use
tunneled catheter facts
used for long term use or chronically ill
least change for infection d/t tunnel and cuff matures and the scar tissue anchors the cath w/in 7 to 10 days then no dressing necessary
ideal for active patients
PICC facts
inserted in peripheral vein nad threaded into the superior vena cava
used for all therapies/blood collection
for pts requiring daily infusion therapies up to 6 mos
can clot more easily
high risk for infection
no vaccum containers when drawing blood
Imported port facts
out of sight
used for 2000 sticks
best for chemo or antibiotics
need a huber needle to access port
change dressing q48 hours
CATHETER RELATED SEPSIS S/S
sudden spike in temp
shoulder pain
look for reddened area and purulent drainage
notify physician
catheter malfunction S?S
access a port and obtain blood return (not just pink tinged fluid) if not clamp, do not flush, notify physician
evravasion
admin of a vesicant substance into the tissues can have a disastrous outcome = fluid gets under the skin
infiltrate
inadvertent admin of non vesicant solution / medication into the surrounding tissues
phlebitis
infusion phlebitis is inflammatin of the vein first sign is tenderness at the insertion site