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flash card from info on PP CVC
N/A
23
Other
Undergraduate 1
05/13/2012

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Cards

Term
Patient in the hospital is transferred form a long term care facility to the hospital for malnutrition and severe dehydration she is 90 yrs old. On examination of her skin you find it to be paper thin with several areas bruised from previous blow veins. The doctor has ordered TPN for this pt. what sort of line do you think the doctor will order for this pt and why?
Definition
This patient will recieve a central venous line because they have limited vascular access (blown veins, age and dehydration contributing to this) and will have to have TPN which is a hypertonic solution (there-for to costic to put in a periferal site.)
Term
You walk into the patients room and they are laying in bed with a large portion of there chest covered in blood. As you rush to inspect you find blood freely pulsing from a broken lumen on a central line. What should you do
Definition
get a hemastate out and clamp the line closed on the luman above the break then call for help (doctor and other nurses)
Term
Why do we inspect the end of catheters when they are removed?
Definition
to insure that it is completely intact (no peice of it has broken off and is now floating about the circulatory system)
Term
benifit of nontunneled central venous catheter
Definition
can be inserted quickly
Term
what are the disadvantages of a nontunneled cantral venous catheter?
Definition
Not flexible and may break
Dislodged more easily
Has the highest infection rate
Term
Your read your patients chart and see that they are recieving chemotherapy on a regular basis what sort of central venous catheter would you expect them to have: tunneled or nontunneled?
Definition
tunneled because chemotherapy is a long term therapy
Term
Your patient has had a dacron cuff inserted a month ago and is on immunosuppressants. Do they require a dressing?
Definition
Yes; they are on immunosuppresants which makes them immunocompromised (lowered immune system)
Term
How often should the caps on the central venous catheters be changed?
Definition
Every two days
Term

Which one of these catheters only has to be flushed once every thirty days and only needs saline to flush?

Hickman

Broviac

Groshong

Definition
Groshong
Term
What are some disadvantages to small gauge PICC lines?
Definition
Fluids infuse slower, harder to draw blood back from, and may occuld easily.
Term
Why do we check the length of the PICC line when we are in the patients room?
Definition
To verify it against the chart and make sure that it has not moving out of the vein.
Term
What is valsalva manuver and when is it used?
Definition
bearing down as though one were about to deficate and it is used during the insertion of a CVC in the subclavian or jugular
Term
If you don't get blood return through a lumen should you use it?
Definition
no call the doc and get order for a clot buster
Term
What is a turbulent flush and why do we use it?
Definition
It is a stop and start means of flushing used to make sure that nothing accumulates on the end of the catheter
Term
What are SAS and SASH?
Definition

Saline Antibiotic Saline (this is method when line is continuously used)

Saline Antibiotic Saline Heprin (this is procedure when line is intermittenly used)

Term
external tubing is changed ever (  ) hrs.
Definition
96
Term
Is dressing change for CVC a sterile or unsterile technique?
Definition
sterile
Term
How often should dressings be changed when transparent or gauze?
Definition
transparent changed every seven days gauze every other day or when they become souled, wrinkeled (edges lifting from skin) or loose
Term
What do you have to document in teh pt. chart?
Definition
condition of site, type of dressing used, condition of the site and length of the catheter when appropriate
Term
What do you do with the inital blood return from a catheter site when drawing blood for labs?
Definition
discard it and flush with saline (10cc) and heprin (if indicated) afterwards
Term
What would be discharge insturction for a patient going home with a CVC?
Definition
Proper handwashing and principles of sterile technique
Dressing change procedure and frequency
Flushing and cap change procedure and frequency
Observation of cath and insertion site
Term
When should the patient call the doctor about their CVC?
Definition
Temp of 100.5F or greater
Chills, dyspnea, dizziness
Pain, redness, swelling, or drainage at site
Unresloved resistance, pain or fluid leaking when flussing 
Hole or tear in cath
Excessive bleeding at site
Change in length of external cath
Swelling in neck, face, chest, or arm
Term
General safety measures are?
Definition
No sharp objects near cath
Clamp cath when not in use
No pulling or tension on the cath
Discard syringes and needles in sharps container
Activity limitations
Use a stress loop
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