Central Line Care and Vascular Access Flashcards
6 cards from real CPHON practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Central Line Care and Vascular Access flashcards as text
What is the primary advantage of a tunneled central venous catheter (e.g., Broviac or Hickman) over a non-tunneled central line in pediatric oncology?
Answer: The subcutaneous tunnel reduces CLABSI risk and allows long-term use over months to years
Tunneling the catheter under the skin creates a mechanical barrier to bacterial migration from the skin exit site to the bloodstream, reduces CLABSI rates, and makes the catheter suitable for long-term use (months to years) compared to non-tunneled devices.
A nurse is preparing to access an implanted venous port in a 7-year-old for chemotherapy. In what order should the following steps be performed?
Answer: Apply topical anesthetic → palpate septum → clean with chlorhexidine → insert Huber needle → verify placement by aspirating blood → flush with normal saline
The correct sequence for port access is: apply topical anesthetic (well in advance) → palpate the port septum → clean with chlorhexidine antiseptic → insert Huber needle perpendicular to septum → verify with blood aspiration → flush with normal saline.
A 5-year-old's central line dressing appears soiled and has lifted at one edge. The catheter was last dressed 5 days ago. The nurse should:
Answer: Perform an immediate dressing change using sterile technique with chlorhexidine-based antiseptic
A soiled, non-intact dressing requires immediate change regardless of the usual schedule. The compromised dressing no longer protects the exit site from microorganism entry, increasing CLABSI risk.
Which action violates best practice when drawing blood cultures from a pediatric central venous catheter?
Answer: Using the same catheter lumen for blood draw and antibiotic infusion simultaneously
Drawing blood cultures through a lumen that is simultaneously used for antibiotic infusion risks contaminating the culture with the antibiotic, leading to false-negative cultures and inaccurate pathogen identification.
A child is receiving a continuous infusion through a double-lumen Broviac when the proximal lumen tubing disconnects accidentally. The most immediate nursing action is:
Answer: Clamp the proximal catheter hub immediately, then apply a sterile cap while maintaining aseptic technique
Immediate clamping of the disconnected lumen prevents air entrainment (air embolism) and blood backflow. A sterile cap should then be placed on the hub using aseptic technique. The hub and connection should be cleaned with antiseptic before reconnecting new tubing.
What is the correct syringe size to use when flushing a pediatric central line, and why?
Answer: 10 mL or larger, because smaller syringes generate dangerously high pressure that can rupture the catheter
Smaller syringes generate much higher pressures per unit force applied because the plunger area is smaller. Using syringes smaller than 10 mL (especially 1 mL or 3 mL) can exceed catheter pressure tolerances and cause rupture or catheter fracture.