1
Q
what is the purpose of a CVAD?
A
- Medication delivery IV
- Nutritional replacement
- Fluid delivery IV
- Blood product delivery IV
- Long term IV therapy
- Poor peripheral IV access
- Frequent blood samples
- Certain types of invasive monitoring (critical care)
2
Q
What are important points about the device?
A
- catheter tip should be in SVC
- femoral line tip should be in IVC
- x-ray to confirm placement
- has 1-3 lumens
- tunneled (can get infected) or implanted
- use 10cc bcz bigger so less pressure.
3
Q
what are the different lumes used for?
A
all lumens:
- IV solution and meds. (generally each is used for one thing and labeled)
distal:
- blood administration (largest lumen)
medial:
- TPN (safest location)
proximal:
- blood samples (least contaminated)
4
Q
what are complications of CVAD?
A
- infection
-occlusion - catheter fracture, leak, migration
- air emboli
- pneumothorax/hemothorax
5
Q
what to do if suspected CVAD infection?
A
- assess pt
- teaching
- C&S of exit site
- catheter and tip for C&S
- CBC
- Blood cultures (x2)
6
Q
what to do if suspected CVAD occlusion?
A
1) flushing - resistance
2) stop infusion
3) follow hospital protocol
4) notify md
7
Q
what to do if suspected CVAD catheter fracture, leak , migration?
A
1) stop infusion
2) assess pt and stay w pt
3) notify md
8
Q
what to do if suspected CVAD air emboli?
A
- clam all lines
- turn pt to LEFT LATERAL, HEAD DOWN
- call for help
- assess pt (VS)
- apply o2
- establish PIV
- continue monitoring
9
Q
what to do if suspected CVAD pneumothorax/hemothorax?
A
- notify md
- give o2
- assist w catheter removal
- chest tube insertion
- x-ray post insertion
