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Vascular Access Device Management Flashcards

7 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with a PICC line develops a fever of 38.9°C and chills during an infusion. What is the priority nursing action?

    Answer: Stop the infusion and notify the provider immediately

    Fever and chills during infusion through a central vascular access device suggest catheter-related bloodstream infection (CRBSI), requiring immediate cessation of infusion and provider notification.

  2. Which technique is used to remove air from IV tubing before connecting to a central venous catheter?

    Answer: Purging the line by allowing fluid to flow through until air-free

    Priming (purging) the IV tubing before connection removes air and prevents air embolism, a serious complication of central venous catheter use.

  3. A nurse is caring for a patient with an implanted port. Which needle type must be used to access an implanted port?

    Answer: Non-coring (Huber) needle

    Non-coring (Huber) needles have an angled bevel that displaces the port septum without cutting it, preserving septum integrity for repeated access.

  4. When assessing a peripheral IV site, which finding requires immediate catheter removal?

    Answer: Mild redness extending 2 cm from the insertion site

    Redness extending 2 cm from the insertion site indicates phlebitis (Grade 2 or higher), which requires catheter removal per INS standards.

  5. A tunneled central venous catheter has a dacron cuff. What is the primary purpose of this cuff?

    Answer: To act as a bacterial barrier and anchor the catheter subcutaneously

    The dacron cuff promotes fibrous tissue ingrowth, anchoring the tunneled catheter subcutaneously and providing a mechanical barrier against bacterial migration.

  6. Which catheter-to-vein ratio is recommended to minimize thrombosis risk when placing a PICC line?

    Answer: The catheter should occupy no more than 45% of the vein lumen

    INS guidelines recommend a catheter-to-vein ratio of ≤45% to allow adequate blood flow around the catheter and reduce thrombosis risk.

  7. When discontinuing a PICC line, what position should the patient be placed in, and why?

    Answer: Trendelenburg position to reduce risk of air embolism

    Trendelenburg (or supine with Valsalva) positioning increases intrathoracic pressure and reduces the risk of air embolism during PICC removal.