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A comprehensive set of questions and answers related to vascular access devices, covering various types of catheters, their indications, contraindications, and placement techniques. It is a valuable resource for students and professionals preparing for the va-bc certification exam or seeking to enhance their knowledge in this area.
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What is the French Scale? - ANS✔✔-- Measurement of the outside size (diameter) of a catheter What is the gauge range of IV catheters? - ANS✔✔-- 24ga to 12 ga Why are all I.V. devices manufactured in the USA are required to be radiopaque? - ANS✔✔-- To facilitate location of catheter emboli in the event of shearing or fracture
List indications for Vascular Access: - ANS✔✔-- 1. Total parenteral nutrition (TPN)
**2. Partial parenteral nutrition
How many short peripheral catheter insertion attempts per healthcare provider are allowed? - ANS✔✔-- 2 What additional veins in pediatrics may be used for non-irritating/non-vesicant infusions? - ANS✔✔-- Metacarpal, cephalic or basilic, scalp veins if <18mo What are the indications for a midline catheter? - ANS✔✔---Infusions projected for 6 days- 4 weeks
What are contraindications for short peripheral catheters? - ANS✔✔--- Placement into an arm with fracture, trauma, infection, or compromised circulation
Popliteal veins Saphenous veins What are the indications for non-tunneled catheters? - ANS✔✔--Short term central vein access Emergency central vein access Why is a patient placed in slight Trendelenburg position for non-tunneled catheter placement? - ANS✔✔--to avoid the possibility of air emboli during the placement procedure In non-tunneled catheter or PICC placement., what should always be avoided when accessing veins? - ANS✔✔--Blind-stick attempts. Prior to any infusion of non-tunneled catheters, how should tip location be confirmed? - ANS✔✔--ECG technology or radiograph What must be obtained prior to ANY infusion of a non-tunneled catheter or a PICC line? - ANS✔✔--A free flowing blood return What is the optimal tip location for a non-tunneled and PICC catheters? - ANS✔✔--Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non- tunneled and PICC catheters? - ANS✔✔--Inferior vena cava (IVC) above the level of the diaphragm Why is the femoral vein is commonly used in pediatric critical care units for non- tunneled catheter placement? - ANS✔✔--Due to ease of insertion in young patients Why may the jugular vein be the preferred point of insertion in very young children for non-tunneled catheters? - ANS✔✔--To avoid a pneumothorax What are the indications for placement of a PICC line? - ANS✔✔---Patients who require central venous access when the duration of the infusions are unknown
What are the contraindications for tunneled catheter placement? - ANS✔✔--
When (upon physician approval) may a tunneled catheter be maintained without a dressing? - ANS✔✔--Once the cuff has developed tissue attachment and the exit site is healed, In pediatric pts. with tunneled catheters, why do we assess/verify internal catheter tip location as the child grows? - ANS✔✔--To maintain internal tip in the SVC What are the indications for an implanted port? - ANS✔✔--Infusions that are projected to continue for months to years What are the contraindications for an implanted port? - ANS✔✔---Severe coagulopathy
What type of needle is used to access an implanted port? - ANS✔✔--Non- coring needle What are power-injectable catheters? - ANS✔✔--Power-injectable catheters are made of polyurethane and engineered to withstand high pressure > pounds per square inch (PSI) What are power injection catheters used for? - ANS✔✔--Used for power injection of I.V. contrast media for a computerized tomography (CT) or magnetic resonance imaging (MRI) scan What are indications for an intraosseous device? - ANS✔✔--As an alternative to venous access in emergency situations What are contraindications for intraosseous placement? - ANS✔✔---Trauma or fracture in the area of access
In emergency situations, in what population are IO devices often used? - ANS✔✔--Infants and children What are indications for dialysis or apheresis catheters? - ANS✔✔-- Hemodialysis, apheresis for plasma or platelets What are possible vessels selected for dialysis/apheresis catheters? - ANS✔✔--Jugular, subclavian, or femoral vein Generally, what size are dialysis or apheresis catheters? - ANS✔✔-- Catheter lumen size is generally 13 to 16 gauge Why are dialysis/apheresis catheters more rigid? - ANS✔✔--To facilitate rapid blood flow Which catheter insertions are surgical precures and required anesthesia? - ANS✔✔--Implanted ports, tunneled catheters, Dialysis/apheresis catheters. Where is the optimal tip location for a dialysis/apheresis catheter? - ANS✔✔--Upper right atrium What are indications for an aerial catheter? - ANS✔✔--Monitoring arterial pressure, arterial blood draws and organ specific infusions
What is the contraindication for an aquapheresis catheter? - ANS✔✔--Lack of an accessible basilic vein in upper arm What vessel is selected for an aquapheresis catheter? - ANS✔✔--Basilic vein above the antecubital bend For what things are Aquapheresis catheters are not recommended? - ANS✔✔--Not recommended for infusions of fluids or medications What is the optimal tip location for an aquapheresis catheter? - ANS✔✔-- 1 - 2 centimeters below the axilla What vessels are available to use with pediatric umbilical catheters? - ANS✔✔--2 umbilical arteries 1 umbilical vein During what time frame may umbilical vessels be accessed? - ANS✔✔--Up to the 4th day of life. What are appropriate uses of an umbilical catheter located in a VEIN? - ANS✔✔---Blood sampling
What are appropriate uses of an umbilical catheter located in an ARTERY? - ANS✔✔---Blood sampling
What is aseptic technique? - ANS✔✔---A specific type of aseptic technique where key areas of items to be used for an infusion cannot be touched prior to insertion.
What effect can alcohol have on the skin? - ANS✔✔--Alcohol irritates and dries the skin What is the purpose of a disinfectant wipe? - ANS✔✔--To kill bacteria, viruses, and fungi on inanimate objects Surface disinfectant are used on what type of surfaces? - ANS✔✔--Use on hard, nonporous surfaces and equipment In line placement, when are surface disinfectants used? - ANS✔✔--prior to setting up sterile field and between patient use What is the purpose of adhesive remover? - ANS✔✔--Removes sticky residue from tape or dressings What factors may affect the activity and effectiveness of an antiseptic solution? - ANS✔✔--a. Organism's concentration in that specific area of the skin b. Organism's composition c. Concentration of the antimicrobial agent
