Anatomy & Vascular Access Evaluation Flashcards
7 cards from real PICC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Anatomy & Vascular Access Evaluation flashcards as text
What minimum internal diameter of the target vein is generally recommended to accommodate a PICC catheter without causing significant flow restriction?
Answer: Greater than 3 mm
A minimum vein diameter of at least 3 mm (ideally larger) is recommended to maintain adequate blood flow around the catheter and reduce thrombosis risk.
Which anatomical structure at the mid-upper arm can be identified by ultrasound as a hyperechoic, pulsatile structure lying medial to the basilic vein?
Answer: Brachial artery
The brachial artery lies medial to the basilic vein in the mid-upper arm and is identifiable by its thick, pulsatile walls on ultrasound.
A PICC nurse is assessing a patient with a history of multiple prior PICCs in the right arm. Ultrasound reveals a patent right basilic vein but echogenic material within the right brachial vein. What is the correct course of action?
Answer: Use the right basilic vein only if it is patent and adequate in size
Thrombosis in the brachial vein does not preclude use of the patent basilic vein; however, the patent vessel must be assessed for adequate diameter and compressibility.
The 'Zone B' insertion site for PICC placement refers to which region of the arm?
Answer: Upper arm between the antecubital fossa and the axilla
Zone B (the upper arm) is the preferred PICC insertion zone because it allows for larger vein selection and reduces complication rates compared to antecubital (Zone A) insertion.
Which of the following conditions is an absolute contraindication to PICC placement in a specific extremity?
Answer: End-stage renal disease with an arteriovenous fistula in that arm
An arteriovenous fistula or graft is an absolute contraindication for ipsilateral PICC placement because instrumentation risks fistula damage, infection, and thrombosis.
On chest radiograph, a PICC tip seen at the level of the carina is considered to be in which location?
Answer: Too high — in the proximal SVC
A tip at the carina corresponds to the proximal to mid-SVC, which is above the optimal cavoatrial junction and may require repositioning.
Which maneuver can be used intraoperatively to redirect a PICC catheter that has malpositioned into the internal jugular vein during insertion?
Answer: Turning the patient's head toward the ipsilateral shoulder and flexing the chin down
Turning the head toward the ipsilateral shoulder and flexing the chin compresses the internal jugular vein, preventing or redirecting catheter entry into it.