Exam (elaborations)
VA-BC QUESTIONS AND ANSWERS
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VA-BC QUESTIONS AND ANSWERS
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VA-BC QUESTIONS AND ANSWERSWhat size needle do you need for blood?
How do you know if you cannulated an artery?
You have a 16 year old patient and the PICC appears to be on the left side, how do you
determine its in the vein and not artery? - Answers- 20-24
Bright red blood
Preform ABG
Patient needs one dose of vanco what would you recommend?
How do you determine IO position placement? - Answers- Midline
across abdomen
If patient states NO IV what do you?
What body position do you do for PICC removal?
What arm position for PICC removal?
When should dressing be changed? - Answers- Recommend IV
upward
arm below
2 days with gauze, 7 days without gauze
Which line has the less incidence of infection?
What values are considered for chronic kidney?
What should you use for a HD cath? - Answers- PORT
GFR under 60 and creatinine above 2
Large bore double lumen
How long should you flush for?
How long can the umbilical cord be used?
Why is vein selection harder in babies? - Answers- 2 times the length of catheter
14 days
less options
Which part of the vessel has the most smooth muscle?
Abian family wants everything done even though patients outcome is death what do you
do? - Answers- media
respect there cultural beliefs on death.
What should you consider for Device Selection in adults?
What are the pediatric considerations? - Answers- Patient assessment like: preference,
lifestyle, willingness to preform maintenance, history, complications, review of variables
to determine correct VAD, high risk factors, advantages and disadvantages.
limited selection, fewer veins, VAD's preserve vessels, caregiver education, avoid scalp
vad's in infants rolling, avoid lower extremity Vad's for crawling patients.
,What are the Indications for short peripheral catheters? - Answers- infusion for 6 days
or less.
non-irritating and non-vesicant medications and solutions.
What are the contraindications for short peripheral catheters? - Answers- Placement
into arm with fracture,trauma, infection, or compromised circulation.
Veins in the arm on the side of a mastectomy, breast surgery, lymph node dissection, av
fistula or graft.
What are the preferred vessels for Short peripheral catheters? - Answers- metacarpal,
cephalic, basilic, accessory veins in arm.
What are the insertion procedures for short peripheral catheters? - Answers- follow
guidelines, aseptic technique, 2 attempts per provider, limit of 2 providers, smallest
gauge possible to deliver therapy.
What are pediatric considerations for short peripheral catheters? - Answers-
Metacarpal, cephalic, basic, scalp and saphenous veins may be used. Use imaging
devices to minimize iv attempts and secure with approved devices.
What are the indications for MIDLINE catheters? - Answers- infusion for 6 days to 4
weeks.
Non-irritating and Non-vesicant medications or solutions.
The left SVC dumps into what?
When should the arterial line set up be changed?
How often do you change arterial lines? - Answers- coronary sinus
96 hrs
as needed
Best way to keep the pulmonary artery catheter free of infection?
How often do you change IV setups?
What does the Swan (Pulmonary artery catheter) measures? - Answers- put in sleeve
96 Hrs
CO (cardiac output)
CDC guideline for max barrier include what?
Should you cut a PICC with a distal valve?
What is optimal placement for a MIDLINE? - Answers- Sterile gloves, cap, gown, full
body sterile drape.
NO
1 inch below axilla
, What are the contraindications for a MIDLINE? - Answers- Placement in arm with
fracture, trauma, infection, AV fistula, or compromised circulation. Chronic kidney
disease patients.
What is the vessel selection for Midline? - Answers- Basilic or cephalic vein in
antecubital fossa
What is the insertion procedures for MIDLINE? - Answers- Follow guidelines, sterile
technique, max sterile barrier precautions, 2 attempts per provider, PICC for midline
risks liability as its against midline DFU.
What are the supplies and the optimal tip location for MIDLINE? - Answers- Midline
device, sterile insertion tray, ultrasound, normal saline flush, dressing supplies.
One inch below the axillary area.
What are the Pediatric considerations for MIDLINE? - Answers- alternative vein
selection like the scalp, popliteal, and saphenous veins.
What are the indications and Contraindications for Non-Tunneled Catheters? -
Answers- Short term and emergency central vein access.
neck and chest sites excluded for trach patients, neck dissection, cervical fracture, or
unstable airway. unable to position, insert, or stabilize catheter. Avoid same side as
PICC.
What is the vessel selection for Non-tunneled catheters? - Answers- Jugular,
Subclavian, or femoral veins
What are the insertion procedures for non-tunneled catheters? - Answers- Antimicrobial
catheters for high risk patients, Follow guidelines, maximum sterile barrier precautions,
put in slight trendelenburg to avoid air emboli, avoid blind stick, use ECG for tip location,
check for blood return prior to infusion.
What are the supplies for a non-tunneled catheters? - Answers- Non-tunneled
percutaneous venous catheter, sterile procedural insertion tray, max sterile barrier
precautions, Ultrasound, normal saline flush, Heparin flush, dressing
What is the Optimal tip location for non-tunneled catheters? - Answers- Cavoatrial
juncture, inferior vena cava at diaphragm if inserted in femoral vein.
What are the indications for a PICC? - Answers- Patients who require a central venous
access when duration is unknown. irritating and vesicant agents.
What are the Contraindications for a PICC? - Answers- Placement in arm with fracture,
trauma, infection, amputation, paralyzed (thrombosis risk), compromised circulation.
Chronic kidney disease patients.
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