Central Line Care and Vascular Access Flashcards
5 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 5 Central Line Care and Vascular Access flashcards as text
A patient receiving vincristine IV via peripheral access complains of burning pain at the infusion site and the nurse notes blanching around the insertion point. The nurse's priority action is:
Answer: Stop the infusion immediately, leave the needle in place, aspirate residual drug, and notify the provider for extravasation management
Vincristine is a vesicant — extravasation causes severe tissue necrosis. The infusion must stop immediately, the needle is kept in place to aspirate residual drug, and the provider is notified. Warm packs (not cold) and hyaluronidase are used for vinca alkaloid extravasation.
Which type of central line requires a non-coring Huber needle for access and is fully implanted under the skin?
Answer: Implanted venous port (Mediport, Port-a-Cath)
Implanted venous ports (Mediport, Port-a-Cath, etc.) are fully subcutaneous devices accessed by inserting a non-coring Huber needle through the skin and into the silicone septum. Standard needles core the septum and are prohibited.
What is the most effective strategy for preventing CLABSI in pediatric oncology patients according to evidence-based practice?
Answer: Adherence to a central line bundle including hand hygiene, maximal sterile barrier, chlorhexidine skin antisepsis, optimal site selection, and daily assessment of line necessity
The CDC's central line bundle (CLABSI prevention bundle) is the most evidence-based intervention for preventing CLABSI: hand hygiene, maximal sterile barrier precautions during insertion, chlorhexidine antisepsis, subclavian/PICC site preference, and daily reassessment of line necessity.
A nurse assessing a tunneled central line exit site in a neutropenic child notes mild erythema, warmth, and serous drainage without fever or systemic signs. What is the most appropriate immediate action?
Answer: Obtain an exit site swab for culture and notify the provider
In a neutropenic patient, even mild exit site signs require prompt provider notification and culture because infection can rapidly progress to bloodstream infection without typical inflammatory signs due to impaired immune response.
When using a needleless connector (NC) for central line access, which disinfection technique is recommended to prevent CLABSI?
Answer: Scrub the hub vigorously for 5–15 seconds with 70% alcohol or chlorhexidine/alcohol swab and allow to dry completely before accessing
Vigorous 'scrub-the-hub' technique with 70% isopropyl alcohol or chlorhexidine-alcohol combination swab for 5–15 seconds, followed by complete drying, is required before every needleless connector access to prevent CLABSI.