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Nur611 Exam 1 – With 387 Questions And Proper Answers 2024/2025
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Nur611 Exam 1 – With 387 Questions And ProperAnswers 2024/2025
1. purpose of IV therapy: hydration nutrition
med administration
2. choosing vascular access: based on medications needed to be administeres, length
of stay/care w/ goal of minimizing # of accesses, attempts, and risk for adverse
reaction
3. access standards of care: location gauge size # of attempts chlorhexidine
bacteriostatic dressings/caps scrub hub (15 seconds)
site check
environment
flushing (3-5cc PIV, 10cc
CIV) blood return
4. continuous IV site check: performed q/h
5. intermittent IV site check: performed Q8H and/or prior to med administration
6. tubing standards of care: never leave tubing uncapped change continuous tubing
Q96H change TPN tubing Q24H
change blood product tubing every unit
7. peripheral IV: 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
8. peripheral IV sites: cephalic, basilic, saphenous, external jugular, antecubital,
dorsal venous, scalp
9. care of peripheral line: assess, flush for patency, maintain dressing, removal
10. catheter sizes and flow rates:
,11. midline catheters: "long peripheral line"// sterile location: terminates in area of
axillae
meds: blood draw dwell time: up to 4 weeks
12. midline catheter sites: basilic and cephalic veins
13. midline catheter uses: blood draw
PPN
pts with difficult IV access
14. Central intravenous therapy: Used to infuse fluids due to rapid hemodilution in
the SVC.
1. Ensure X-ray verification of tip prior to use
2. Insertion occurs in the OR, the clients room, or outpatient facility using
sterile technique.
3.Tunneled and implanted catheters require surgical removal
4. Types: nontunneled, percutaneous central venous catheters (CVC), PICC, tunneled
central venous catheters (Hickman, Groshong).
15. Nontunneled percutaneous central venous catheter (CVC): Description: 18 to
25cm (7-10 inch) in length w/ 1-5 lumens. Length of use: short-term (<6w)
Insertion location: SV, JV; tip in the distal
Indications: emergent or trauma use, admin of blood, admin of chemotherapeutic agent,
antibiotics, and TPN
16. Tunneled percutaneous central venous catheter: For long-term use
,Insertion: A portion of the catheter lies in a subcutaneous tunnel separating the point
where the catheter enters the vein from where it enters the skin with a cuff. Tissue
granulates into the cuff to provide a mehhanical barrier to organisms and anchoring.
Indications: Frequent-long term need for vascular access
Groshong catheters have pressure-sensitive valves to prevent blood reflux and do not
require a clamp.
17. central line flushing: some (open ended catheters) require heparin flushes to
prevent clogging with fibrin; while some (valved catheters) do not
18. PICC line: Description: 45-74 cm (18-29 inch) with single or multiple lumens.
Length of use 12m
Insertion: basilic or cephalic vein at least one fingerbreath above or below the AC fossa.
Should be advanced until tip is in the lower 1/3 of the SVC.
Indications: Administration of blood products, long-term admin of chemo, antibiotics,
and TPN (vesicant therapy meds with pH <5 or >9 long term fluid therapy (>4 weeks)
parenteral nutrition glucose ?10%)
when possible insert early before veins are exposed to various venous punctures
19. PICC line Considerations: Preprocedural:
Ensure informed consent has been signed
Cleanse the site with chlorhexidine
Ensure sterility of equipment
Place STOP sign to restrict entry during procedure
Postprocedural: confirm placement with X-ray. Asses the site for redness, swelling,
drainage, tenderness, and condition of the dressing
Clean insertion port with alcohol for 15 seconds (or use valve disinfection caps.
Use transparent dressing (change q/7)
NO BP IN ARM WITH PICC & DO NOT GET WET.
20. PICC line indications: infection endocarditis hyperemesis osteomyeltits cancer
pancreatitis bowel obstruction nutritional support
21. PICC line care: -Use a 10mL for PICC (do not exceed resistance) -Flush before
and after med admin (10 mL)
-Flush 20mL 0.95 sodium chloride after blood products
-Flush 5 mL heparin when not in use
22. systemic bacteremia: pt w/ this infection must have - bcxs for 48hrs before a picc
can be placed
, 23. lumens: each provides independent access to venous circulation to allow
incompatible drugs or fluids to be infused simultaneously
24. infusion valve: opens with minimal pressure and automatically closes after
infusion
25. aspiration valve: opens for sampling and automatically closes to resist pressure
fluctuations that may cause reflux
26. closed valve: remains closed during normal increases in CVP to prevent reflux
27. valved catheters: 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
28. three way valve: a valve with three ports (one inlet and two outlets) used to divert
flow direction and allows for blood draw
29. implanted ports: Description: Small reservoir covered by a thick septum Insertion
site: surgically implanted into the chest wall. Catheter inserted into the Subclavian
and terminates in the SVC.
Indications: Long-term- 1yr or more need for vascular access (chemotherapy)
30. implanted ports care: Specific trained individuals wearing a mask and aseptic
technique during access. -Apply topical anesthetic
-Acess with Huber needle
-Check blood return prior to med admin.
-Flush with heparin 10 units m/L or 0.9% sodium chloride after every use and at
least q/m
require:
weekly dressing change
needle change with each dressing
31. Mechanical Complications: Dislodged catheter tip& or port. Use only noncoring
(huber) needle to avoid damaging the mesh of the port. Manifestations of dislodged
port include swelling, unrestricted movement of the port, and inability to access.
Manifestations of dislodged catheter tip include gurgling/swishing sounds, pain on
affected side (neck or ear).
32. local complications: hematoma (bruise) inflitration extravastation phlebitis
thrombophlebitis infection
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