Which of the following would be reasons for giving parenteral nutrition? Select all that apply.
A.
Traditional IV fluids do not provide sufficient calories or nitrogen to meet daily body requirements
B.
Patient's inability to ingest or absorb food orally
BC
Parenteral nutrition is given through a central vein because: Select the best answer
A.
It is less invasive than a peripheral IV
B.
The high flow of blood rapidly dilutes the concentrated PN solution in a central vein
C.
There are fewer complications poss
C
Which of the following is part of the procedure from a central VAD?
A.
Flush the port with Heparin and then withdraw the blood in the same syringe
B.
Draw blood using the same technique as with venipunctures
C.
Discard the first 1-2 vials of blood drawn b
C
Parenteral nutrition is initiated rapidly and advanced quickly to the desired rate
True or False
False
Nursing care during parenteral nutrition includes monitoring, weight, I & O, and blood sugar
True or False
True
Dextrose concentrations greater than 10% should not be given through a peripheral vein to prevent phlebitis
True or False
True
Intravenous fat emulsions (lipids) may be given simultaneously with parenteral nutrition, but connected lower on the IV line through a Y-connector close to the infusion site and should not be filtered.
True or False
True
The parenteral nutrition solution cannot be initiated until the central catheter's position is confirmed with x-ray or fluoroscopy.
True or False
True
An infusion pump is always necessary to administer parenteral nutrition
True or False
False
The most common vessel used to insert a non-tunneled central catheter is the
Femoral
What other vein can be used?
Internal Jugular
The catheter is advanced until the distal tip rests in the
Superior Vena Cava
A type of central venous access device inserted above the antecubital space along the arm is known as a __________________ or its abbreviation _____.
Peripherally Inserted Central Catheter or PICC
What two procedures should be avoided along the extremity with the above device?
Blood pressure, venipuncture and injections
The purpose of threading the tunneled catheter under the skin to enter the subclavian vein several inches away is to ____________________________. This type of catheter is a _______ (long or short)-term use device.
Stabilize the catheter; long term use
What type of central catheter is being described below? ________________
* Inserted surgically into subcutaneous pocket
* Has a small chamber connected to the catheter
* Access is done with a non-coring (Huber) needle, through the skin
* Allows patient fr
Implanted port
_____________________ may occur if PN is discontinued abruptly.
Hypoglycemia
The _____________________________ content of parenteral nutrition solution makes these solutions ideal culture media for bacterial and fungal growth
Nutrient
To help prevent the complications of air embolism in a patient with a central line, the nurse should use the three C's for managing the ports. What are the three C's?
Clamped, capped, connected
The patient having a central venous line inserted into the subclavian vein experiences the following signs and symptoms: sudden, sharp chest pain; cough; sudden shortness of breath; hypotension; pallow; and anxiety. What complication do you suspect? _____
Pneumothorax
List at least eight (8) things to teach the client and/or family with a VAD for PN, being discharged to home.
1) Aseptic care of line and flushing technique, tape connections and secure a loop of tubing to dressing
2) Signs and symptoms of infection
3) Avoid vigorous contact sports
4) For kids, inform babysitters, teachers, school nurse, etc.
5) If line becomes b
Which of the following is not a type of VAD?
A.
Mediport
B.
Central venous catheter
C.
Tunneled lumen catheter
D.
Dobhoff feeding tube
D
Following central venous catheter insertion, the client should be assessed for:
A.
Pneumothorax
B.
Stroke
C.
Myocardial infarction
D.
Pulmonary embolism
A
Which of the following is a serious, immediate complication that can occur when opening a central catheter to room air?
A.
Air embolism
B.
Infection
C.
Catheter clotting
D.
Hemorrhage
A
All of the following are indications for using central VAD's except:
A.
Prolonged antibiotic therapy
B.
Central venous pressure monitoring
C.
Venipuncture on a client with a phobia of needles
D.
Prolonged total parenteral nutrition
C
A major advantage of a PICC line is:
A.
Insertion can be done by a specially trained and certified nurse, making its use less expensive
B.
It is sutured securely in place
C.
No flushing is required
D.
It does not affect body image
A
Central VAD dressing and cap changes requires all of the following safety factors except:
A.
Use bandage scissors to cut the old dressing off to facilitate its removal
B.
The cap is changed while having the client hold his or her breath and bear down (Val
A
Health teaching for the client going home with a central venous catheter should include:
A.
Expect redness and drainage at the catheter exit site
B.
If the catheter leaks, clamp the catheter between the break and your skin immediately
C.
Getting the dress
B
You notice that the area around your client's PICC line appears red, warm to the touch, and tender to palpation. You suspect:
A.
Phlebitis
B.
Infiltration
C.
Infection
D.
Clot within the catheter
C
A type of central venous access device inserted above the antecubital space along the arm is known as a:
A.
Dobhoff
B.
Triple lumen
C.
PICC
D.
Mediport
C
Outline the SAS steps for intermittent drug administration via a central venous catheter:
1) ____________________________
2) ____________________________
3) ____________________________
1) Saline (flush with 10 mL)???
2) Administer medication or IV???? medication
3) Saline?? (flush with 10 mL)