Patient Assessment & Care Planning Flashcards

A patient with stage 4 chronic kidney disease needs 10 days of IV antibiotics. Which device best supports vein preservation?

Answer: Small-bore tunneled CVC via the internal jugular vein

Patients with CKD stage 3b or higher should avoid arm PICCs and midlines to preserve veins for future AV fistula creation.

What is the maximum recommended osmolarity for parenteral nutrition infused through a peripheral catheter?

Answer: 900 mOsm/L

PN above 900 mOsm/L requires a central vascular access device because of the risk of phlebitis.

Using ultrasound before PICC placement, what is the maximum recommended catheter-to-vein ratio?

Answer: 45% or less

INS standards recommend a catheter-to-vein ratio of 45% or less to reduce the risk of thrombosis.

A patient had a left mastectomy with axillary node dissection and has left-arm lymphedema. Where should a peripheral IV be placed?

Answer: Right forearm

Avoid the limb with lymphedema or impaired lymph drainage and use the unaffected arm.

A nurse makes two unsuccessful attempts to place a peripheral IV in a patient with difficult venous access. What is the best next step?

Answer: Escalate to a clinician skilled in ultrasound-guided insertion

INS limits each clinician to 2 attempts and recommends escalating to a more skilled clinician or using visualization technology.

Which site is preferred for a short peripheral catheter in an adult?

Answer: Forearm veins such as the cephalic or basilic

Forearm veins avoid areas of flexion, extend dwell time, and lower the risk of complications.

A patient with difficult venous access needs 10 days of peripherally compatible IV therapy. Which device is most appropriate?

Answer: Ultrasound-guided midline catheter

MAGIC criteria support midlines for peripherally compatible therapy expected to last up to about 14 days.