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NURS 611 Exam 1: Questions With Complete Answers
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NURS 611 Exam 1: Questions With Complete Answers
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NURS 611 Exam 1: Questions With Complete Answerspurpose of IV therapy Right Ans - hydration
nutrition
med administration
choosing vascular access Right Ans - based on medications needed to be
administeres, length of stay/care w/ goal of minimizing # of accesses,
attempts, and risk for adverse reaction
access standards of care Right Ans - location
gauge size
# of attempts
chlorhexidine
bacteriostatic dressings/caps
scrub hub (15 seconds)
site check
environment
flushing (3-5cc PIV, 10cc CIV)
blood return
continuous IV site check Right Ans - performed q/h
intermittent IV site check Right Ans - performed Q8H and/or prior to med
administration
tubing standards of care Right Ans - never leave tubing uncapped
change continuous tubing Q96H
change TPN tubing Q24H
change blood product tubing every unit
peripheral IV Right Ans - short term catheter inserted into any vein that is
not in the chest or abdomen
function: non irritating and non vesicant meds
dwell time: therapy > 5 days
peripheral IV sites Right Ans - cephalic, basilic, saphenous, external jugular,
antecubital, dorsal venous, scalp
,care of peripheral line Right Ans - assess, flush for patency, maintain
dressing, removal
catheter sizes and flow rates Right Ans -
midline catheters Right Ans - "long peripheral line"// sterile
location: terminates in area of axillae
meds: blood draw
dwell time: up to 4 weeks
midline catheter sites Right Ans - basilic and cephalic veins
midline catheter uses Right Ans - blood draw
PPN
pts with difficult IV access
central line (CVAD) Right Ans - tip terminates in the SVC
long dwell times
types of central lines Right Ans - PICC
non-tunneled CVC
tunneled CVC
implanted port
central line flushing Right Ans - some (open ended catheters) require
heparin flushes to prevent clogging with fibrin; while some (valved catheters)
do not
PICC line Right Ans - peripherally inserted central catheter
location: tip terminates in the SVS
dwell time: 6mos-1yr
PICC line uses Right Ans - vesicant therapy
meds with pH <5 or >9
long term fluid therapy (>4 weeks)
parenteral nutrition glucose ?10%
PICC line indications Right Ans - infection
endocarditis
,hyperemesis
osteomyeltits
cancer
pancreatitis
bowel obstruction
nutritional support
PICC line care Right Ans - verify placement
pink band
dressing changes q/7days
flushing with 10cc
risks
systemic bacteremia Right Ans - pt w/ this infection must have - bcxs for
48hrs before a picc can be placed
lumens Right Ans - each provides independent access to venous circulation
to allow incompatible drugs or fluids to be infused simultaneously
infusion valve Right Ans - opens with minimal pressure and automatically
closes after infusion
aspiration valve Right Ans - opens for sampling and automatically closes to
resist pressure fluctuations that may cause reflux
closed valve Right Ans - remains closed during normal increases in CVP to
prevent reflux
valved catheters Right Ans - no need for heparin flush since valve is closed
when not being used so fibrin is less likely to clog line; requires 10mL NS flush
per day or before and after use instead
three way valve Right Ans - a valve with three ports (one inlet and two
outlets) used to divert flow direction and allows for blood draw
non-tunneled catheter Right Ans - catheter put directly into the subclavian
of internal jugular vein
short term use only d/t high infection rate
, tunneled catheter Right Ans - longer catheter, which is channelled under
the skin from the point of insertion in the vein to an exit site; specialized cuff
attached to line; lower infection rate
implanted ports Right Ans - type of central delivery for long term access
placed under the surface of the skin; tip in the SVC
implanted ports care Right Ans - less infection risk; accessed via huber
needle;
require:
heparin flush
weekly dressing change
needle change with each dressing
central line care Right Ans - determine NEED
verify placement (measurement)
dressing changes once a week
line length
flushing
risks
local complications Right Ans - hematoma (bruise)
inflitration
extravastation
phlebitis
thrombophlebitis
infection
systemic complications Right Ans - anaphylaxis (Latex products * typically)
air embolism
catheter embolism
sepsis
air embolism Right Ans - a bubble of air in the bloodstream; prevent by
clamping, keeping lines capped, appropriate use of IV pump, and priming your
tubing
infiltration s/s Right Ans - edema, swelling, blanching, coolness,
tenderness, discomfort
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