Line Insertion & Maintenance 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 Line Insertion & Maintenance flashcards as text
Which catheter gauge is most appropriate for power injection of IV contrast through a PICC?
Answer: 18 Fr or larger (power-injectable rated)
Power injection requires a power-injectable PICC rated for the flow rates and pressures used in CT contrast administration, typically 4–5 mL/sec.
A PICC placed in the right arm has migrated into the right internal jugular vein as confirmed on X-ray. The most appropriate next action is:
Answer: Have the patient turn their head toward the insertion side and reposition under fluoroscopy
Repositioning maneuvers (head turn, arm repositioning, fluoroscopic guidance) can redirect a malpositioned PICC from the IJ back into the SVC.
When obtaining blood cultures through a PICC, the nurse should:
Answer: Collect one set from the catheter and one from a peripheral site to differentiate CRBSI from bacteremia
Paired blood cultures (catheter vs. peripheral) allow differential time-to-positivity analysis to determine whether the catheter is the infection source.
Needle-free connectors (NFC) on PICC lines should be changed:
Answer: Every 72–96 hours per INS guidelines or per manufacturer instructions
INS standards recommend changing NFCs at least every 72–96 hours, concurrent with tubing changes, to minimize infection risk.
To confirm PICC tip placement, the gold standard imaging modality is:
Answer: Chest X-ray (posteroanterior or anteroposterior projection)
Chest X-ray remains the standard method for verifying PICC tip position before initiating infusion therapy.
A nurse notes blood backflow into the PICC extension tubing that is not resolving with repositioning. This finding most likely suggests:
Answer: Elevated central venous pressure or a valve issue in the connector
Blood reflux into extension tubing can result from elevated CVP, negative intrathoracic pressure, or a faulty needleless connector valve.
Which of the following is a contraindication to PICC placement in a specific arm?
Answer: AV fistula or graft on that extremity
An arteriovenous fistula or graft is a contraindication because PICC insertion risks thrombosis, infection, and permanent damage to the dialysis access.