Which of the following is the most common type of vascular access device Quizlet

1. needs infusion of a large volume of fluid

2. requires multiple infusions,

3. requires long-term infusion therapy (e.g., antibiotics, chemotherapy, etc.),

4. needs infusion of irritating medications such as potassium,

5. needs infusion of fluids with high osmolarity such as total parenteral nutrition (TPN),

6. needs hemodialysis/plasmapheresis,

7. for injection of contrast media for a diagnostic test.

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Occlusion - follow routine flushing with positive pressure; flush between medications

Catheter Migration - Avoid trauma; avoid placement near site of local disease

Extravasation - Assess site frequently for signs of infiltration

Thrombosis -- low dose oral anticoagulant therapy; avoid excessive force when flushing catheter

Air Embolism - always clamp when not in use; never leave catheter open to air

Catheter damage, breakage - use needleless system to access port

Infection - use strict hand hygiene and aseptic technique

The nurse is performing a dressing change for a central vascular access device. The nurse performs hand hygiene, applies clean gloves and a mask. The nurse removes the old dressing in the direction opposite of how the catheter was inserted, noting drainage and appearance of insertion site. The nurse inspects the catheter and hub for intactness, removes clean gloves, and performs hand hygiene. The nurse opens the dressing kit and applies clean gloves. The nurse cleans the exit site with alcohol swabs by swabbing the exit site in a horizontal plane, then a vertical plane, followed by a circular motion (from the middle outward). The nurse repeats with chlorhexidine swabs and applies a transparent dressing. The nurse labels the dressing with date, time of dressing change, and initials. The nurse disposes of soiled supplies, removes gloves, performs hand hygiene, and documents the procedure. Which of the following actions made by the nurse require correction? (Select all that apply.)

A. The type of gloves worn to remove the old dressing
B. The type of gloves worn to apply the new dressing
C. The direction the nurse removed the old dressing
D. The direction the nurse used to clean the exit site
E. The information the nurse put on the label of the new dressing
F. The time between swabbing the site and application of dressing

1. Gather supplies first
2. Explain procedure to patient
3. Position patient on back
4. Provide privacy
5. Wash hands and don mask
6. Have client turn head away from catheter insertion site

7. Open sterile central line dressing kit
8. Don clean gloves and remove old dressing
9. Be careful not to dislodge the catheter
10. Inspect site for infection
11. Inspect catheter for signs of leakage or other problems

12. Don sterile gloves
13. Cleanse catheter site with > 0.5% chlorohexidine preparation (2011 CDC recommendation)
14. Clean in a circular motion, moving from the insertion site outward to the edge of the adhesive border
15. Allow solution to dry

16. Apply new dressing:
- Apply a sterile air occlusive dressing

17. If patient is diaphoretic or site is oozing
- Apply sterile gauze around the catheter
- Apply transparent semi-permeable dressing

18. Secure tubing with tape
19. Label dressing with date, time, your initials

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