Managing Infusion Complications Flashcards
6 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Managing Infusion Complications flashcards as text
What is the INS grading scale for phlebitis, and what grade requires catheter removal?
Answer: Grades 0-4; remove at grade 2 or above
The INS Visual Infusion Phlebitis scale ranges from 0-4; grades 2 and above (pain with erythema or edema) indicate the catheter should be removed and restarted at a new site.
A patient with a port-a-cath presents with inability to aspirate blood but the port flushes without resistance. What is the MOST likely cause?
Answer: Fibrin sheath formation at the catheter tip
A fibrin sheath acts as a one-way valve, allowing infusion (antegrade flow) but preventing blood withdrawal (retrograde flow into the catheter).
What are the signs and symptoms of catheter pinch-off syndrome?
Answer: Intermittent difficulty flushing or aspirating that worsens with arm adduction or shoulder movement
Pinch-off syndrome occurs when a subclavian catheter is compressed between the clavicle and first rib, causing intermittent occlusion with positional changes.
How should the CRNI manage extravasation of a vesicant drug when the specific antidote is not available?
Answer: Aspirate as much drug as possible, elevate the extremity, and consult with pharmacy and physician immediately
When an antidote is unavailable, the priority is to aspirate residual drug through the catheter, elevate the extremity, and immediately consult pharmacy and the physician for alternative management.
A patient receiving IV vancomycin develops tinnitus and dizziness. What should the nurse assess?
Answer: Serum vancomycin trough level for potential ototoxicity
Tinnitus and dizziness during vancomycin therapy suggest ototoxicity, which correlates with elevated serum trough levels and requires immediate level assessment.
What is the significance of catheter-related thrombosis in patients with PICCs compared to other central venous catheters?
Answer: PICCs are associated with higher rates of upper extremity DVT compared to other CVCs
PICCs are associated with significantly higher rates of upper extremity deep vein thrombosis compared to subclavian or jugular CVCs, particularly in hospitalized patients.