PICC Patient Education & Documentation 3 — Questions and Answers
Question 1: A home care nurse is reinforcing PICC education for a patient with low health literacy. Which strategy is most effective?
- Provide a detailed written pamphlet with medical terminology
- Use simple language, visual aids, and repeated teach-back (Correct answer)
- Have the patient watch a 30-minute instructional video once
- Ask family members to explain the information to the patient
Correct answer: Use simple language, visual aids, and repeated teach-back
Simple language, visuals, and teach-back are evidence-based strategies for patients with low health literacy.
Question 2: What must a nurse document after each PICC dressing change?
- Only the date and time
- Site assessment findings, dressing type used, lot numbers, and patient tolerance (Correct answer)
- The patient's pain score only
- The catheter brand and insertion date only
Correct answer: Site assessment findings, dressing type used, lot numbers, and patient tolerance
Comprehensive dressing change documentation includes site assessment, supplies used, and patient response.
Question 3: A patient reports that their PICC dressing has become wet and is peeling at the edges. What should the nurse document and teach?
- This is expected and requires no action until the scheduled change
- The dressing should be reinforced with medical tape only
- The dressing must be changed immediately and the patient should always report compromised dressings (Correct answer)
- The patient should apply a dry gauze layer over the existing dressing
Correct answer: The dressing must be changed immediately and the patient should always report compromised dressings
A wet or loose dressing compromises the sterile barrier and must be changed promptly to prevent infection.
Question 4: When documenting catheter tip location after PICC placement, which is the acceptable confirmed position?
- Subclavian vein
- Upper arm basilic vein
- Lower third of the superior vena cava at the cavoatrial junction (Correct answer)
- Right atrium
Correct answer: Lower third of the superior vena cava at the cavoatrial junction
The PICC tip should rest at the lower third of the SVC near the cavoatrial junction for optimal flow and reduced thrombosis risk.
Question 5: A patient asks why nurses document each time they flush the PICC. What is the best response?
- It is required only for billing purposes
- Documentation tracks catheter patency, confirms saline use, and supports infection surveillance (Correct answer)
- It is done only when problems occur
- Flushing documentation is optional in outpatient settings
Correct answer: Documentation tracks catheter patency, confirms saline use, and supports infection surveillance
Flushing documentation supports assessment of catheter patency, verifies correct technique, and aids in infection surveillance.
Question 6: Which of the following should be included when educating a patient about when to call their healthcare provider regarding their PICC?
- Only call if they see blood in the tubing
- Call for any fever over 100.4°F, site redness, swelling, pain, or inability to flush (Correct answer)
- Wait 48 hours before reporting any concern
- Only call during business hours for non-emergency concerns
Correct answer: Call for any fever over 100.4°F, site redness, swelling, pain, or inability to flush
Patients should be instructed to report fever, site changes, or flushing difficulty immediately as these may indicate infection or occlusion.
Question 7: A nurse documents 'patient education deferred' on admission. What additional information is required?
- No additional information is needed
- The reason for deferral and a plan for when education will occur (Correct answer)
- Only the date the education will be rescheduled
- A supervisor's countersignature
Correct answer: The reason for deferral and a plan for when education will occur
Deferred education must include the clinical reason (e.g., sedation, acute distress) and a documented plan for completing it.
PICC Patient Education & Documentation 3
A home care nurse is reinforcing PICC education for a patient with low health literacy.
Which strategy is most effective?