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NUR 211 Exam Questions And Answers @ 2024
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NUR 211 Exam Questions And Answers @ 2024Why do you use CVADs
For people who need frequent or special access to the vascular system.
What are the three main types of CVAD's
Centrally, inserted, catheters, peripherally, inserted central catheter (PICCs), and
implanted ports.
Where are CVAD's placed
Large blood vessels: subclavian vein and jugular vein
What are the advantages of CVADs
1. Immediate access to the central venous system
2. a reduce need for multiple venipunctures
4. decrease risk for extravasation injury.
5. frequent, continuous, rapid, or intermittent administration of fluids and medication.
6. Administer more safely blood, blood products and drugs that are potential vesicants.
7. Useful with patients who have limited peripheral vascular access or who have
projected need for long-term vascular access.
8. Can also use to inject radiopaque contrast media.
What are vesicants?
Agents deck and caused tissue damage
What are major disadvantages of CVAD's
- Increased risk for systemic infection
- Invasiveness of the procedure.
- Extravasation can still occur if there is displacement of or damage to the device.
Where are non-tunneled catheter usually placed
The subclavian, or internal jugular vein, I more rarely in the femoral vein
,T or F: centrally, inserted, catheters are best for patients with short term needs in an
acute care settings.
True
What are some surgically placed tunneled catheter's?
Hickmann, Broviac, Groshong.
T or F: surgically placed tunneled catheter's are suitable for long-term needs
True
The tip of centrally inserted catheters, also called, central venous catheter's (CVCs) rest
in the distal end of
The superior vena cava, near its junction with the right atrium. And the other end exists
through the separation incision on the chest or abdominal wall.
What is a PICC line?
A central venous catheter inserted into a vein in the arm
What is the best vein to insert a PICC line
The basilic vein, because of its large diameter.
The cephalic, median cubital or brachial veins are other options
PICCs are used with patients who need vascular access for how long
One week to six months but they can be in place for longer periods.
Advantages of PICC over CVC
-Lower infection rate
-fewer insertion related complications
-decrease costs
-ability to insert at the bedside or in an outpatient area.
T or F: Do not use the arm with the PICC to take a blood pressure reading or draw blood
True
PICCs have an increased risk for
Deep vein, thrombosis, and phlebitis
T or F: phlebitis occurs. It usually happens within 7 to 10 days after insertion of a PICC
line.
,True
What is an implanted infusion port?
-A surgically implanted, central venous catheter connected to a reservoir or port.
-The catheter tip lies in the desired vein.
-The port lies in a surgically created subcutaneous pocket on the upper chest or arm.
-It consists of a titanium, or a plastic reservoir, covered with a self sealing silicone
septum
How do you access an implanted infusion port?
-You access the port by using a special noncoring needle with a deflected tip.
-This prevents damage to the septum that could make the port useless.
What is the benefit of implanted infusion ports?
-They are good for long-term therapy
-low risk for infection
-Hidden port offers patients cosmetic advantages
-overall has less maintenance than other types of CVAD's.
What should you monitor with implanted in fusion ports
Infiltration that can occur if the needle is not in place or dislodged
Midline catheter's
-Don't enter a Central vein
-Use and care are similar to a PICC
-A specially trained nurse can insert a midline catheter
-Can be 3 to 8 inches long and have single or double lumen
-Insertion in the antecubital area, through either the basilic or cephalic vein often under
ultrasound guidance
The tip rest right below the axilla, stay in below the shoulder joint to reduce the risk for
vein, irritation from moving the shoulder.
-Can stay in place for up to four weeks
What are nursing management of CVAD's
, -Assessment
-Dressing changes and cleansing
-Injection cap changes
-maintenance of catheter patency
-Follow Agency guidelines
Catheter and insertion site assessment includes
Inspecting the site for redness, edema, warmth, drainage, tenderness, or pain.
Observe catheter misplacement or slippage.
What to look out for when performing a pain assessment in a patient with CVAD's?
Reports of chest or neck, discomfort, arm, pain, or pain at the insertion site.
T or F: do not use a newly placed CVAD until the tip position is verified with a chest x-ray
True
Differentiate between the size of the distal, middle and proximal lumen, and the
recommended uses of each when using a multi lumen catheter
Triple lumen catheter, include the proximal lumen port 18G, distal lumen port 16G, and
medial lumen port 18G.
The distal port (middle line) is usually the largest of the three lines.
T or F: CVAD's are available in single double or triple lumens.
True
Multi lumen catheters are used in
Critically ill patients to allow for simultaneous use: allows for infusion of incompatible
drugs and fluids, as well as blood sampling.
PowerPICC catheters
-Allows for injection of contrast media for CT scans at a maximum rate of 5 ml/sec
-Device is clearly labeled.
-Ensure line is patent
What are typical dressing used for CVAD's
-Transparent semi permeable dressing, allows for observation of the site without having
to remove the dressing.
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