Infection Prevention & Complication Management 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 Infection Prevention & Complication Management flashcards as text
A PICC nurse is performing a blood culture draw from a PICC in a febrile patient. Which technique is required to correctly differentiate CRBSI from other bacteremia sources?
Answer: Draw paired blood cultures simultaneously from the PICC and a peripheral vein
Paired simultaneous blood cultures — one through the PICC and one from a peripheral vein — are required to calculate differential time to positivity (DTP) for CRBSI diagnosis.
What differential time to positivity (DTP) threshold, when the PICC culture turns positive earlier than the peripheral culture, is diagnostic for catheter-related bloodstream infection (CRBSI)?
Answer: ≥2 hours
A DTP of ≥2 hours — the central line culture turning positive at least 2 hours before the peripheral culture — is the accepted diagnostic threshold for CRBSI.
Which organism is most commonly responsible for CLABSI in patients with long-term PICCs receiving home infusion therapy?
Answer: Coagulase-negative Staphylococci
Coagulase-negative Staphylococci, particularly S. epidermidis, are the most common organisms causing CLABSI, especially with long-term indwelling catheters, due to their strong biofilm-forming capacity.
A patient's PICC site has a transparent semipermeable membrane (TSM) dressing that is visibly lifting at the edges and has moisture under it. The correct action is to:
Answer: Change the dressing immediately using aseptic technique
A compromised dressing with lifting edges and moisture underneath must be changed immediately, as moisture under the dressing significantly increases CLABSI risk.
Which intervention is most effective in preventing biofilm formation on PICC lumens used for prolonged therapy?
Answer: Using antimicrobial-impregnated or antibiotic lock solutions in high-risk patients
Antimicrobial lock solutions (e.g., ethanol, minocycline-EDTA, or taurolidine) have demonstrated efficacy in reducing biofilm-associated CLABSI in high-risk or recurrent-infection patients.
A patient develops unilateral arm edema and facial swelling on the side of a PICC insertion. Chest X-ray shows catheter tip in the subclavian vein. Which complication is most likely?
Answer: Catheter malposition with tip in the subclavian vein rather than SVC/CAJ
Facial and arm swelling with a catheter tip confirmed in the subclavian vein (not at the SVC/CAJ) indicates malposition, as the short non-central tip can impede venous return and cause thrombosis.
Which action should a PICC nurse take when a patient reports a burning sensation, coolness, and swelling at the infusion site during an infusion of a vesicant agent?
Answer: Stop the infusion, aspirate residual drug, and manage per vesicant extravasation protocol
Vesicant extravasation requires immediate cessation of infusion and aspiration of residual drug followed by specific antidote administration per institutional vesicant protocol to minimize tissue damage.