AVA CERTIFICATION EXAM | Questions with Questions Answered Correctly
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Course
AVA
Institution
AVA
Difficult Catheter Advancement Interventions - ANSWER *If resistance is met, stop and
assess catheter advancement
*Withdraw catheter a short distance and
redirect *Adjust arm
*Ask patient to cough
*Ask patient to turn head to side
*Refer to IR
AVA CERTIFICATION EXAM | Questions
with Questions Answered Correctly
Difficult Catheter Advancement Interventions - ANSWER *If resistance is met, stop and
assess catheter advancement
*Withdraw catheter a short distance and
redirect *Adjust arm
*Ask patient to cough
*Ask patient to turn head to side
*Refer to IR
Malposition of Catheter - ANSWER Abherret catheter tip location after initial
placement as indicated on CXR. Risks are venous thrombosis and vessel erosion
Malposition of Catheter Causes - ANSWER *Mis-direction on insertion
*Aberrant vasculature
*Stenosis/Thrombosis
*Pacemaker
*AICD
*Venospasm
*Over-insertion of CVAD
*Short catheter
*Increased intrathoracic pressure (vent, cough, forceful flushing)
*High central venous pressure (CHF, Pulmonary HTN)
Malposition of Catheter Signs and Symptoms - ANSWER *May be no signs
and symptoms
*Difficult advancement
, *Discomfort with advancement
*Patient reports flushing sound
*Lack of or poor blood return
*Difficulty moving catheter
*Guidewire is kinked
*Resistance with flush
*CXR reveals malposition
Malposition of Catheter Prevention - ANSWER *Review medical history
*Accurate pre-measurement
*US guidance
*Pre-scanning and selection of vessel
*If resistance is met, retract and re-advance
slowly *US scan of IJ to rule out jugular
malposition *Immediate post placement CXR
Malposition of Catheter Intervention - ANSWER *If malpositioned in jugular, rapid
flushing may flip catheter to SVC
*Reposition arm
*Pull back catheter that is too deep
*Consider catheter exchange or IR
Catheter or Wire Embolus - ANSWER Complication of leaving a catheter fragment
or guide wire in situ are thrombosis, infection, post-phlebitic syndrome, arrythmias,
cardiac/vascular damage
Catheter or Wire Embolus Causes - ANSWER *Operator error
*Over insertion of guidewire
*Shearing of catheter/wire by pulling
*Complete rupture of catheter with small
syringe *Rapid CVAD insertion
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