PICC PICC Pharmacology & Medication Administration 1 — Questions and Answers
Question 1: Which pH range of medications is considered vesicant and requires central venous access such as a PICC for safe administration?
- pH 6.0–8.0
- pH 5.0–9.0
- pH less than 5 or greater than 9 (Correct answer)
- pH 4.5–7.5
Correct answer: pH less than 5 or greater than 9
Solutions with a pH less than 5 or greater than 9 are vesicants that can cause severe tissue damage and require central venous access like a PICC for safe delivery.
Question 2: A patient is receiving vancomycin through a PICC line. Which laboratory value must be monitored to ensure therapeutic dosing and prevent toxicity?
- Serum creatinine and vancomycin trough levels (Correct answer)
- Complete blood count (CBC)
- Liver function tests (LFTs)
- Prothrombin time (PT/INR)
Correct answer: Serum creatinine and vancomycin trough levels
Vancomycin is nephrotoxic and ototoxic, so serum creatinine and trough levels must be monitored to ensure therapeutic dosing and prevent toxicity.
Question 3: Which medication classification is considered an absolute indication for central venous access due to peripheral vein toxicity?
- Isotonic saline solutions
- Vesicant chemotherapy agents such as doxorubicin (Correct answer)
- Oral anticoagulants converted to IV
- Standard maintenance IV fluids
Correct answer: Vesicant chemotherapy agents such as doxorubicin
Vesicant chemotherapy agents like doxorubicin cause severe tissue necrosis on extravasation and must be administered through confirmed central venous access such as a PICC.
Question 4: A PICC nurse is preparing to administer total parenteral nutrition (TPN). Which PICC lumen is the preferred choice for TPN infusion?
- The lumen used most recently for blood draws
- A dedicated lumen used exclusively for TPN (Correct answer)
- The smallest lumen available
- Any available lumen in a multilumen PICC
Correct answer: A dedicated lumen used exclusively for TPN
TPN should be administered through a dedicated lumen to prevent incompatibility reactions and reduce infection risk from co-infusion with other medications.
Question 5: Which two medications are commonly used together via PICC in outpatient settings and require close monitoring for potential incompatibility?
- Normal saline and dextrose 5% in water
- Cefazolin and heparin flush
- Ampicillin and gentamicin (Correct answer)
- Morphine and normal saline
Correct answer: Ampicillin and gentamicin
Ampicillin and gentamicin are physically and chemically incompatible; they must not be mixed or infused simultaneously through the same PICC lumen.
Question 6: Before administering phenytoin via a PICC line, the nurse should ensure the catheter is flushed with which solution to prevent precipitation?
- Dextrose 5% in water (D5W)
- Normal saline (0.9% NaCl) (Correct answer)
- Lactated Ringer's solution
- Sterile water for injection
Correct answer: Normal saline (0.9% NaCl)
Phenytoin precipitates in dextrose solutions; the PICC must be flushed with normal saline before and after administration to prevent catheter occlusion.
PICC PICC Pharmacology & Medication Administration 1
Which pH range of medications is considered vesicant and requires central venous access such as a PICC for safe administration?