Lecture 6. Exam 4
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Central Louisiana Technical Community College *
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Feb 20, 2024
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Lecture 6 IV Therapy
1.
What is the preferred vein of choice for a PICC line insertion?
Basilic
2.
How to confirm PICC placement and accuracy insertion?
X-ray 3.
When irrigating a central line, the barrel capacity of a syringe needs to be no greater than what?
10mL
4.
How do we flush a central line with at least 10mL of saline?
Use push pause method and instil 2 mls with every push
5.
How to draw blood from a central line? Select all that apply.
Infusate turned off ( 1 full minute) proximal port, 10mL flushed with NS (Push pause method) 5-10 mL discard 1
st
, flushed 20 mL NS
6.
Know the catheter positions designed for a PICC line. Where the tip is suppose to be placed.
In the upper arm veins and advanced to the level of the upper SVC and sometimes into the RA. 7.
Indications for using a central venous catheter (where its a short central catheter or a PICC line). Different reasons
Used when the traditional route of short-term venous access is not practical.
Complex or advanced disease processes or conditions
Requirement of special medication or treatments
Inadequacy of peripheral venous access d/t poor or fragile veins, inadequate size of veins
Necessity of rapid absorption and rapid blood and tissue perfusion
Long-term IV therapy in the hospital, home, or OP setting 8.
Which device is placed SQ in a patient?
Central implanted port
Lecture 6 IV Therapy
9.
Why do we use a heparin flush for a central catheter?
To maintain patency 10.
Why is a central line more likely to be placed in a vessel on the right side of the neck or right side of the body?
The path to the SVC is less tortuous and associated with lesser chance of tension pneumothorax 11.
Why is the tip of the central catheter needs to stay outside of the
right atrium?
Dysrhythmias or become entrapped in the tricuspid valve and cause valvular damage that may require replacement surgery 12.
Know the different complications from not using a sterile technique when placing a central line.
Local infection
Sepsis
Thrombosis 13.
How to keep an air embolism from occurring when we provide care to a central line?
The patient if able should be instructed to perform the Valsalva maneuver to reduce the risk of an air embolism 14.
If you suspect an air embolism in a patient, how would you respond? Position to put the patient.
Left trendelenburg position 15.
If you are given TPN, which port would use exclusively for TPN and nothing else
Medial port
16.
What lumen designation tells us about a central line.
Distal port: high volume or viscous fluids, medications- largest lumen and closest to heart
Proximal port: blood sampling- least likely to be influenced by infusates
Lecture 6 IV Therapy
Medial port: reserved exclusively for TPN, if TPN isn’t used, may deliver meds through this port
Fourth lumen- fluids or medication administration 17.
Know any of the times to change a dressing cover for central or peripheral catheter
Usually every 7 days or PRN when the dressing is loose, wet, or nonocclusive 18.
What is an LPN approved and not approved according to the LSPNE
Observe, assess, initiate, manipulate, and maintain IV therapy relative to central lines ( including administration of IV medications by IVPB or IVP, hyperlimenation, blood and blood products)
Care for clients with external venous catheters (including Hickman, Groshong, Brovia) and specifically: obtain blood specimens/connect and monitor IVF’s/connect IVPB, provide site care (including dressing changes).
Care for clients with internal venous access devices (including port-a-cath, life port) and specifically: access with and/or remove
Huber needle/draw blood/connect and monitor IVF’s, and provide
site care (including dressing changes).
Know what the RN is not allow to delegate to a LPN.
Administration of investigational drugs
Administration of cancer therapeutic drugs
Administration of medications by IV push, other than those defined by health agency protocol for emergency situations
Administration of blood and blood products
Administration of TPN solutions
Accessing the implanted device 19.
Where does the tip of the catheter lays when assessing a femoral
vein for a central venous catheter?
IVC, via the femoral vein 20.
What is the name of the needle we use to assess a central infusion port?
Huber
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