Term
|
Definition
| Difficulty flushing, sluggish infusion, absent or sluggish blood return |
|
|
Term
| S/S of local infection r/t PICC |
|
Definition
| Erythema, induration (hardness at site), tenderness, swelling, drainage at site |
|
|
Term
| S/S of systemic infection r/t PICC |
|
Definition
| Fever, hypotension, elevated white blood cell count, confusion, decreased urinary output |
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|
Term
| S/S of infiltration & extravasation r/t PICC |
|
Definition
• Aching/discomfort in the shoulder and neck - (most common)
• Pain or burning of chest wall
• Leakage from catheter exit site
• Swelling of chest wall
• Aching/discomfort in the chest wall
• Fluid leakage at or around exit site and along subcutaneous canal. |
|
|
Term
| What is the difference between extravasation and infiltration? |
|
Definition
Extravasation is the inadvertent administration of a vesicant (irritating) drug or solution from a vein into surrounding healthy tissue. Vesicants can cause blistering, severe tissue damage, and necrosis.
Infiltration is inadvertent administration of a nonvesicant drug into surrounding tissue. |
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|
Term
| S/S of thrombosis r/t PICC |
|
Definition
| Pain, tenderness or numbness in the neck, shoulder, or arm on affected side of the body |
|
|
Term
| S/S of catheter migration r/t PICC |
|
Definition
| Irregular heart rate or dysrhythmia, frequent N/V and/or frequent, severe episodes of coughing. |
|
|
Term
| S/S of air embolism r/t PICC |
|
Definition
| dyspnea, respiratory distress, or cyanosis |
|
|
Term
| Interventions for broken or leaking catheter: |
|
Definition
| Stop use of catheter. Cover broken part with sterile gauze and tape securely. Call MD. |
|
|
Term
| Intervention for extravasation r/t PICC: |
|
Definition
| Stop infusion, call Rx for antidote for drug, and notify MD. |
|
|
Term
| Intervention for air embolism r/t PICC: |
|
Definition
Close off end of catheter.
Place in Trendelenburg's position on LEFT side.
Notify MD. |
|
|
Term
| Intervention for local or systemic infection r/t PICC: |
|
Definition
| Notify MD. Prepare to remove catheter, obtain blood cultures and administer ABTs. |
|
|
Term
| Intervention for occlusion r/t PICC: |
|
Definition
| Have pt cough and deep breathe, reposition, raise pt's arms. If unsuccessful, call MD. Prepare to obtain x-ray, give bolus of IV fluid or thrombolytic, or to remove catheter. |
|
|
Term
| Intervention for catheter migration r/t PICC: |
|
Definition
Stop all fluid administration.
Call MD. |
|
|
Term
| S/S of VAD complications: |
|
Definition
Pain at insertion site, or in neck, shoulder, arm of affected side.
Elevated body temp.
Specific decrease in BP (drop of 10mmHg)
Irregular and/or increased pulse rate.
Dyspnea
Nausea |
|
|
Term
| T/F Groshong's have clamps |
|
Definition
|
|
Term
PICC dressing Changes:
Describe how to disinfect skin with chlorhexidine gluconate |
|
Definition
| 15-30 sec vigorous scrub. let dry thoroughly and allow to remain on skin |
|
|
Term
PICC dressing Changes:
T/F Antiseptics maximum effectiveness is only achieved if the antiseptic is allowed to air dry thoroughly. |
|
Definition
|
|
Term
PICC dressing Changes:
What should be noted on transparent dressing after each change? |
|
Definition
| Date, initials, and length of exposed tubing in cm's. |
|
|
Term
| T/F Sharp objects such as scissors may be used to help remove PICC dressings. |
|
Definition
|
|
Term
PICC dressing Changes:
In which direction should old dressings be peeled to remove? |
|
Definition
| Peel towards insertion site to prevent accidental removal of the catheter. |
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