Catheter Tip Location & Verification Flashcards

Where should the tip of a midline catheter be located in an adult?

Answer: At or near the level of the axilla, distal to the shoulder

A midline is a peripheral device whose tip sits in the basilic, cephalic, or brachial vein at or below the axilla.

Why is tip placement high in the SVC, rather than at the cavoatrial junction, a concern?

Answer: Higher risk of catheter-related thrombosis

Tips in the upper SVC are linked to more thrombosis because blood flow and hemodilution there are lower.

A CVAD tip lying deep in the right atrium is most associated with which complication?

Answer: Cardiac arrhythmias and possible tamponade

A tip in the right atrium can irritate the myocardium and, rarely, erode through it and cause tamponade.

After CVC insertion, a patient suddenly develops hypotension, muffled heart sounds, and jugular venous distension. What should the nurse suspect?

Answer: Cardiac tamponade

Beck's triad suggests pericardial tamponade, a rare complication of a malpositioned intracardiac tip.

A left-sided CVAD tip rests in the SVC at a perpendicular angle against the vessel wall. Why is this a problem?

Answer: It increases the risk of vessel wall erosion and thrombosis

A tip that abuts the vein wall at a steep angle can erode the wall and promote thrombosis.

On chest radiograph, a left-arm PICC runs down the left side of the mediastinum, with no crossing to the right. Which anatomical variant should be considered?

Answer: Persistent left superior vena cava

A persistent left SVC drains into the coronary sinus and makes a left-sided descending course on imaging.

Which statement about ECG tip confirmation reflects current INS Standards?

Answer: It is accurate enough to replace post-procedure chest radiography in eligible adults

INS supports ECG tip confirmation as an alternative to chest radiography when P waves are interpretable.