Umbilical Catheter Placement and Vascular Access Flashcards
5 cards from real NRP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 5 Umbilical Catheter Placement and Vascular Access flashcards as text
What is the correct landmark for intraosseous needle insertion in a neonate?
Answer: The flat, medial surface of the proximal tibia, approximately 1–2 cm below the tibial tuberosity
The preferred site for IO insertion in neonates is the flat, medial surface of the proximal tibia, approximately 1–2 cm distal (below) to the tibial tuberosity — a site with minimal overlying tissue and a broad, flat marrow cavity.
How does the team confirm correct IO needle placement in a neonate before administering medications?
Answer: The needle stands upright without support, can be aspirated for marrow, and flushes freely without extravasation
IO placement is confirmed by the needle standing upright without support, ability to aspirate marrow (not always possible in neonates), and free flushing with saline without soft tissue swelling or extravasation.
What is the maximum time an emergency UVC placed during delivery room resuscitation should be left in place before being removed or replaced with a properly positioned central line?
Answer: 24–48 hours — it should be removed or repositioned as soon as the infant is stabilized
An emergency UVC placed rapidly in the delivery room without optimal sterile technique or confirmed position should be removed or replaced with a properly placed and confirmed central line within 24–48 hours to reduce infection risk.
During UVC insertion, the catheter advances easily to 5 cm but then meets resistance. What should the operator do?
Answer: Withdraw the catheter to 2–4 cm and attempt to aspirate blood — use this position for emergency access
Resistance during UVC insertion often indicates the catheter has entered a portal vessel or hit the ductus venosus junction. The correct response is to withdraw to the 2–4 cm emergency position and confirm blood can be aspirated there.
What type of solutions should NOT be infused through a UVC until tip position is confirmed by X-ray?
Answer: Hypertonic solutions such as 10–25% dextrose, TPN, or 8.4% sodium bicarbonate
Hypertonic solutions (concentrated dextrose, TPN, high-concentration sodium bicarbonate) should not be infused through a UVC until X-ray confirms the tip is in the IVC or right atrium, as infusion into portal vessels causes severe hepatic injury.