Line Insertion & Maintenance Flashcards

Which vein is considered the FIRST-CHOICE insertion site for PICC placement in adult patients?

Answer: Basilic vein

The basilic vein is preferred because it is larger, straighter, and has fewer valves than the cephalic vein, facilitating easier catheter advancement.

When using ultrasound guidance for PICC insertion, the needle entry angle should typically be:

Answer: 30–45 degrees

A 30–45 degree angle optimizes needle visualization under ultrasound while achieving adequate vein penetration depth.

After successful PICC placement, the ideal catheter tip position is:

Answer: Superior vena cava–right atrial junction

Placement at the cavoatrial junction (lower third of the SVC) allows high blood flow to dilute infusates and reduces thrombosis risk.

A PICC dressing should be changed every 7 days when using a chlorhexidine-impregnated sponge dressing AND whenever the dressing is:

Answer: Damp, loosened, or visibly soiled

INS standards require immediate dressing change if integrity is compromised, regardless of scheduled interval.

Which flushing technique is recommended to prevent PICC occlusion?

Answer: Pulsatile (push-pause) flush followed by positive-pressure cap closure

The pulsatile technique creates turbulence that removes fibrin and drug residue from catheter walls better than a steady flush.

When measuring external PICC catheter length for documentation, the nurse measures from the:

Answer: Skin exit site to the catheter hub

External length is measured from the skin exit site to the hub to track migration of the catheter tip over time.

A nurse notes resistance when flushing a PICC line. The FIRST action should be:

Answer: Assess for kinking, clamp position, or patient arm position

Mechanical causes such as kinking, a closed clamp, or a kinked extension set must be ruled out before assuming a clot occlusion.