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19 Cards in this Set
- Front
- Back
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CVC's have two or more lumens / ports what is each one used for
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Distal = incompatible medication, colloids, viscous fluids
Medial= TNP Proximal= blood sampling, blood admin |
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how do we prevent blood reflux
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maintain positive pressure except for Groshong they have a slit or pressure sensitive valve
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Methods to assist in aspirating blood
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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 |
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Air emobolism interventions
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1 clamp catheter
2. position in left lateral trendenburg 3. admin 100% o2 4. take vital signs 5. notify md |
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S/S of air embolism
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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
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;removing of the CVC
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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 |
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how is contraindicated for the Valsalva maneuver
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increased intracranial pressure, recent eye surgery, myocardial infarcation, experiencing bradycardia or respiratory distress
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procedures for removing a non-tunneled central venous line
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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 |
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4 types of central lines
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non-tunneled
tunneled PICC implanted ports |
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where is the tip of the CVAD located
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superior vena cava = right before the heart
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non-tunneled facts
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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 |
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tunneled catheter facts
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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 |
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PICC facts
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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 |
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Imported port facts
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out of sight
used for 2000 sticks best for chemo or antibiotics need a huber needle to access port change dressing q48 hours |
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CATHETER RELATED SEPSIS S/S
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sudden spike in temp
shoulder pain look for reddened area and purulent drainage notify physician |
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catheter malfunction S?S
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access a port and obtain blood return (not just pink tinged fluid) if not clamp, do not flush, notify physician
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evravasion
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admin of a vesicant substance into the tissues can have a disastrous outcome = fluid gets under the skin
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infiltrate
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inadvertent admin of non vesicant solution / medication into the surrounding tissues
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phlebitis
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infusion phlebitis is inflammatin of the vein first sign is tenderness at the insertion site
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