VA-BC Study Guide Questions With Correct Solution

What size needle do you need for blood? How do you know if you cannulated an artery? You have a 16 year old patient and the PICC appears to be on the left side, how do you determine it's in the vein and not the artery? - ANS 20-24 Bright red blood Preform ABG Patient needs one dose of vanco. What would you recommend? How do you determine IO position placement? - ANS Midline across abdomen If a patient states NO IV what do you do? What body position do you do for PICC removal? What arm position for PICC removal? When should dressing be changed? - ANS Recommend IV upward arm below 2 days with gauze, 7 days without gauze The left SVC dumps into what? When should the arterial line set up be changed? How often do you change arterial lines? - ANS coronary sinus 96 hrs as needed Best way to keep the pulmonary artery catheter free of infection? How often do you change IV setups? What does the Swan (Pulmonary artery catheter) measure? - ANS put in sleeve 96 Hrs CO (cardiac output) CDC guidelines for max barrier include what? Should you cut a PICC with a distal valve? What is optimal placement for a MIDLINE? - ANS Sterile gloves, cap, gown, full body sterile drape. NO 1 inch below axilla Which line has the least incidence of infection? What values are considered for chronic kidney? What should you use for a HD catch? - ANS PORT GFR under 60 and creatinine above 2 Large bore double lumen How long should you flush for? How long can the umbilical cord be used? Why is vein selection harder in babies? - ANS 2 times the length of catheter 14 days less options Which part of the vessel has the most smooth muscle? Abian family wants everything done even though patients outcome is death what do you do? - ANS media respect there cultural beliefs on death. What should you consider for Device Selection in adults? What are the pediatric considerations? - ANS Patient assessment like: preference, lifestyle, willingness to preform maintenance, history, complications, review of variables to determine correct VAD, high risk factors, advantages and disadvantages. limited selection, fewer veins, VAD's preserve vessels, caregiver education, avoid scalp vad's in infants rolling, avoid lower extremity Vad's for crawling patients. What are the Indications for short peripheral catheters? - ANS infusion for 6 days or less. non-irritating and non-vesicant medications and solutions. What are the contraindications for short peripheral catheters? - ANS Placement into the arm with fracture,trauma, infection, or compromised circulation. Veins in the arm on the side of a mastectomy, breast surgery, lymph node dissection, a fistula or graft. What are the preferred vessels for Short peripheral catheters? - ANS metacarpal, cephalic, basilic, accessory veins in the arm. What are the insertion procedures for short peripheral catheters? - ANS follows guidelines, aseptic technique, 2 attempts per provider, limit of 2 providers, smallest gauge possible to deliver therapy. What are pediatric considerations for short peripheral catheters? - ANS Metacarpal, cephalic, basic, scalp and saphenous veins may be used. Use imaging devices to minimize iv attempts and secure with approved devices. What are the indications for MIDLINE catheters? - ANS infusion for 6 days to 4 weeks. Non-irritating and Non-vesicant medications or solutions. What are the contraindications for a MIDLINE? - ANS Placement in arm with fracture, trauma, infection, AV fistula, or compromised circulation. Chronic kidney disease patients. What is the vessel selection for Midline? - ANS Basilic or cephalic vein in antecubital fossa What is the insertion procedures for MIDLINE? - ANS Follow guidelines, sterile technique, max sterile barrier precautions, 2 attempts per provider, PICC for midline risks liability as its against midline DFU. What are the supplies and the optimal tip location for MIDLINE? - ANS Midline device, sterile insertion tray, ultrasound, normal saline flush, dressing supplies.