Clinical Procedures & Techniques Flashcards

Where should the terminal tip of a midline catheter sit 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 near the axilla, distal to the shoulder.

Povidone-iodine is used for skin antisepsis because a patient cannot use chlorhexidine. How long should it be left to dry before puncture?

Answer: At least 1.5 to 2 minutes

Povidone-iodine has to stay on the skin and dry fully, at least 1.5 to 2 minutes, to work as an antiseptic.

According to INS standards, what is the maximum number of peripheral IV attempts recommended per clinician?

Answer: 2 attempts per clinician, with a total limit of 4

INS limits PIV attempts to 2 per clinician and 4 in total before considering another route or device.

When flushing a catheter with a positive-displacement needleless connector, what is the correct order for the last steps?

Answer: Disconnect the syringe, then close the clamp

Positive-displacement connectors push fluid forward when the syringe is removed, so you disconnect first and then clamp.

How often should a transparent semipermeable membrane dressing on a CVAD be changed if it remains clean, dry, and intact?

Answer: At least every 7 days

TSM dressings are changed at least every 7 days, while gauze dressings are changed at least every 2 days.

Which patient position and breathing instruction are recommended when removing a nontunneled central venous catheter?

Answer: Supine or Trendelenburg, with the patient doing a Valsalva maneuver or breathing out during removal

Supine or Trendelenburg positioning with Valsalva or exhalation raises intrathoracic pressure and lowers the risk of air embolism.

After removing a nontunneled CVC, what should go on the exit site?

Answer: An air-occlusive dressing left for at least 24 hours

An air-occlusive dressing, for example petroleum-based, covers the skin-to-vein tract and prevents delayed air embolism.