PICC Anatomy & Vascular Access Evaluation

Question 1

Which vein is least ideal for PICC?

Accepted Answer

Cephalic vein

Answer

While the cephalic vein can be used for PICC insertion, it is generally considered less ideal than the basilic or brachial veins. The cephalic vein often has a smaller diameter, a more tortuous course, and can be more prone to venospasm, making insertion more challenging and increasing the risk of complications like phlebitis or occlusion. Therefore, it is typically avoided if other options are available.

Question 2

Where should PICC tip terminate?

Accepted Answer

Lower third of superior vena cava

Answer

The ideal tip termination for a PICC is in the lower third of the superior vena cava (SVC), just above the cavoatrial junction. This placement ensures that infused medications are rapidly diluted by the high blood flow in the SVC, minimizing irritation to the vessel wall and reducing the risk of complications like cardiac arrhythmias or vessel erosion. Correct tip placement is critical for safe and effective therapy.

Question 3

Why evaluate arm circumference?

Accepted Answer

Check for thrombosis

Answer

Regular measurement of the arm circumference above the PICC insertion site is a vital assessment for detecting potential complications, particularly deep vein thrombosis (DVT). An increase in arm circumference can indicate swelling caused by a thrombus forming in the vein, which can impede blood flow and lead to pain and further complications. Early detection allows for prompt intervention.

Question 4

Which diagnostic tool guides vein selection?

Accepted Answer

Ultrasound

Answer

Ultrasound is the preferred diagnostic tool for guiding vein selection and insertion during PICC placement. It allows for real-time visualization of the veins, enabling the clinician to assess vessel size, patency, and course, as well as identify any anatomical variations or existing thrombi. This guidance significantly improves insertion success and reduces complications compared to blind insertion.

Question 5

What is the function of valves in veins?

Accepted Answer

Prevent backflow of blood

Answer

Veins contain one-way valves that play a crucial role in venous circulation. These valves open to allow blood to flow towards the heart and then close to prevent the backflow of blood, especially against gravity. This mechanism ensures efficient venous return and prevents pooling of blood in the extremities, contributing to overall circulatory health.

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

(PICC) Peripherally Inserted Central Catheter Certified Nurse Practice Test

PICC Anatomy & Vascular Access Evaluation