Insertion Techniques & Complications Management Flashcards
7 cards from real VABC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Insertion Techniques & Complications Management flashcards as text
A patient's implanted port is accessed but the nurse cannot aspirate blood. The patient reports no discomfort. What should the nurse assess FIRST?
Answer: Have the patient perform positional maneuvers such as raising the arm or coughing
Positional maneuvers can relieve a fibrin sheath or positional occlusion and are the first-line, non-invasive assessment for inability to aspirate.
Pinch-off syndrome is a complication specific to which central venous access approach?
Answer: Subclavian via infraclavicular approach
Pinch-off syndrome occurs when the catheter is compressed between the clavicle and first rib, which is unique to the subclavian infraclavicular insertion site.
During femoral vein cannulation, the landmark technique uses the mnemonic NAVEL. What does each letter represent in order from lateral to medial?
Answer: Nerve, Artery, Vein, Empty space, Lymphatics
NAVEL (Nerve, Artery, Vein, Empty space, Lymphatics) describes the lateral-to-medial arrangement of femoral triangle structures below the inguinal ligament.
A PICC patient has a confirmed upper extremity DVT. The catheter is still patent and functional and the patient requires continued IV therapy. What is the recommended approach per current guidelines?
Answer: Anticoagulate and remove the PICC only if it is no longer needed
Current guidelines recommend initiating anticoagulation and removing the catheter only when it is no longer needed, balancing thrombosis treatment with ongoing IV access needs.
Which of the following steps in aseptic technique is MOST critical for preventing catheter-related bloodstream infections (CRBSI) at the time of insertion?
Answer: Using a 2% chlorhexidine-based antiseptic with alcohol and allowing it to fully dry
Maximal sterile barrier precautions including full sterile drape, gown, gloves, mask, and chlorhexidine-alcohol skin prep (allowed to dry) are the most evidence-based insertion practices to prevent CRBSI.
A nurse removes an 18 cm PICC from a patient's basilic vein. After removal, only 15 cm of catheter is retrieved. What should the nurse do IMMEDIATELY?
Answer: Apply a tourniquet above the insertion site and notify the physician immediately
Suspected catheter fracture and embolism requires immediate tourniquet application proximal to the site to limit migration, followed by urgent physician notification and imaging.
Which tip confirmation method for PICC placement provides real-time intraprocedural tip location without radiation exposure?
Answer: Electrocardiographic (ECG) tip confirmation technology
ECG-based tip confirmation detects changes in the P-wave morphology as the catheter tip approaches the SVC-RA junction, allowing real-time radiation-free tip localization.