AVA CERTIFICATION EXAM: VASCULAR
ACCESS DEVICES
In the presence of a newly placed automatic intracardiac defibrillator or pacemaker - ANSAvoid
PICC insertion on ipsilateral side for six months
CVAD insertion in the presents of an IVC filter - ANSCan Inadvertently trap wires in the filter
PIV is indicated for adequate venous availability for indicated therapy. This includes -
ANSNon-vesicants and non- irritants with a pH 5 to 9 and osmolality <600 mOSm/L
PICCS can be utilized for - ANSChemotherapy, TPN, IV solutions and medication, blood
products, plasmapheresis, hemodialysis, diagnosing, frequent blood sampling.
Power Injectable devices are made of polyurethane and withstand high pressure of >300
pounds per square inch to be used during - ANSCT or MRI scan
Tunneled CVAD may be indicated for infants and toddlers receiving - ANSTPN
Axillary lymph node dissection including sentinel node biopsy, requires special considerations
with vascular access placements - ANSUse contralateral arm for PIV or PICC placement.
In morbid obesity the most appropriate vein selection may be - ANSThe cephalic vein.
Ultrasound appearance of a target vein that changes in size from large to small and back again
as you move up the arm - ANSMay represent venous dilatation from a distal stenosis or
occlusion
How does one measure for PICC placement? - ANSPosition arm at 90 degree angle.
Measure from planned insertion site to the right
Clavicular head,
Then down to the third intracoastal space.
Land-marked measuring techniques have
reported failure and complications as high as - ANS30 percent and 18.8 percent respectively
Catheter-related infections most often result from - ANS-contamination of the central venous
catheter
-contamination of the insertion site
-break in sterile technique during insertion
, Maximum sterile barrier protection may reduce the incidence of - ANSCatheter contamination
and CLABSI
Chlorhexidine with alcohol is superior to - ANSPovidone/iodine or isopropyl alcohol
How should Chlorhexidine be applied? - ANSFriction on clean skin for 30
seconds, then allow to dry completely.
How should Chlorhexidine or appropriate skin antiseptic be applied to the femoral area? -
ANSShould be applied for at least two minutes using friction, then allow to dry.
Use 10 ml syringe - ANSTo minimize pressure on the catheter
Lock solutions include - ANSNormal Saline, or Heparinized saline 10 to 1000 units per milliliter
Preferred skin antiseptic for site care. - ANS0.5% Chlorhexidine preparation with alcohol
Allow chlorhexidine to dry completely before applying - ANSSecurement device or transparent
dressing
Catheter removal. Place patient in what position? - ANSSupine or slight Trendelenburg position
If patient inhales during catheter removal what could occur? - ANSAir embolism
After removing the catheter apply what to site? - ANSAntiseptic ointment
Occlusive dressing should remain in place how long after catheter is removed - ANS24 hours
Assessment of PICC. - ANSObserve insertion site and affected arm for signs and symptoms of
potential problems every 8 hours. Exit site bleeding. Exit site infection. Catheter related sepsis
with temperature greater than 101 degrees. External catheter leakage.
Catheter tip malposition - ANSMay complain of gurgling
noise, ear, and neck pain during infusion, catheter embolus or rupture of catheter.
PICC CATHETER
Phlebitis pain, redness, swelling, can appear - ANSanywhere along the cannulated vein.
GROSHONG CATHETER ADVANTAGES - ANSClamping nor Heparin is needed.
Only saline flush is needed.
Irrigate every 7 days and after use.
GROSHONG CATHETHER DISADVANTAGES - ANSSurgery required
ACCESS DEVICES
In the presence of a newly placed automatic intracardiac defibrillator or pacemaker - ANSAvoid
PICC insertion on ipsilateral side for six months
CVAD insertion in the presents of an IVC filter - ANSCan Inadvertently trap wires in the filter
PIV is indicated for adequate venous availability for indicated therapy. This includes -
ANSNon-vesicants and non- irritants with a pH 5 to 9 and osmolality <600 mOSm/L
PICCS can be utilized for - ANSChemotherapy, TPN, IV solutions and medication, blood
products, plasmapheresis, hemodialysis, diagnosing, frequent blood sampling.
Power Injectable devices are made of polyurethane and withstand high pressure of >300
pounds per square inch to be used during - ANSCT or MRI scan
Tunneled CVAD may be indicated for infants and toddlers receiving - ANSTPN
Axillary lymph node dissection including sentinel node biopsy, requires special considerations
with vascular access placements - ANSUse contralateral arm for PIV or PICC placement.
In morbid obesity the most appropriate vein selection may be - ANSThe cephalic vein.
Ultrasound appearance of a target vein that changes in size from large to small and back again
as you move up the arm - ANSMay represent venous dilatation from a distal stenosis or
occlusion
How does one measure for PICC placement? - ANSPosition arm at 90 degree angle.
Measure from planned insertion site to the right
Clavicular head,
Then down to the third intracoastal space.
Land-marked measuring techniques have
reported failure and complications as high as - ANS30 percent and 18.8 percent respectively
Catheter-related infections most often result from - ANS-contamination of the central venous
catheter
-contamination of the insertion site
-break in sterile technique during insertion
, Maximum sterile barrier protection may reduce the incidence of - ANSCatheter contamination
and CLABSI
Chlorhexidine with alcohol is superior to - ANSPovidone/iodine or isopropyl alcohol
How should Chlorhexidine be applied? - ANSFriction on clean skin for 30
seconds, then allow to dry completely.
How should Chlorhexidine or appropriate skin antiseptic be applied to the femoral area? -
ANSShould be applied for at least two minutes using friction, then allow to dry.
Use 10 ml syringe - ANSTo minimize pressure on the catheter
Lock solutions include - ANSNormal Saline, or Heparinized saline 10 to 1000 units per milliliter
Preferred skin antiseptic for site care. - ANS0.5% Chlorhexidine preparation with alcohol
Allow chlorhexidine to dry completely before applying - ANSSecurement device or transparent
dressing
Catheter removal. Place patient in what position? - ANSSupine or slight Trendelenburg position
If patient inhales during catheter removal what could occur? - ANSAir embolism
After removing the catheter apply what to site? - ANSAntiseptic ointment
Occlusive dressing should remain in place how long after catheter is removed - ANS24 hours
Assessment of PICC. - ANSObserve insertion site and affected arm for signs and symptoms of
potential problems every 8 hours. Exit site bleeding. Exit site infection. Catheter related sepsis
with temperature greater than 101 degrees. External catheter leakage.
Catheter tip malposition - ANSMay complain of gurgling
noise, ear, and neck pain during infusion, catheter embolus or rupture of catheter.
PICC CATHETER
Phlebitis pain, redness, swelling, can appear - ANSanywhere along the cannulated vein.
GROSHONG CATHETER ADVANTAGES - ANSClamping nor Heparin is needed.
Only saline flush is needed.
Irrigate every 7 days and after use.
GROSHONG CATHETHER DISADVANTAGES - ANSSurgery required
