Patient Evaluation & Care Coordination Flashcards

A patient is scheduled for a PICC insertion but reports a previous reaction to latex gloves during a prior procedure. Which pre-insertion action is mandatory?

Answer: Ensure a latex-free environment and use non-latex supplies for the entire procedure

A documented latex allergy requires a completely latex-free environment to prevent anaphylaxis; all gloves, equipment, and supplies must be latex-free prior to proceeding.

During vascular access team rounding, which patient would be the highest priority for evaluation of vascular access needs?

Answer: A patient with end-stage renal disease and no current access who requires urgent IV medications

A patient with ESRD, no access, and urgent IV medication needs represents an immediate safety risk requiring prioritized vascular access evaluation and device placement.

A nurse assessing a patient for PICC placement notes the patient is agitated and unable to cooperate with positioning. What is the most appropriate next step?

Answer: Collaborate with the provider to address agitation before insertion, considering sedation or anxiolytic medication

Patient cooperation is essential for safe PICC insertion; uncontrolled agitation increases the risk of movement-related complications, and addressing it with appropriate sedation is required before proceeding.

Which laboratory value, if abnormal, should be reported to the provider before performing a tunneled CVC insertion?

Answer: INR of 3.2

An INR of 3.2 indicates significant coagulopathy that markedly increases bleeding risk during tunneled CVC insertion, requiring provider notification and correction before proceeding.

A vascular access nurse is educating a patient about their newly placed implanted port. Which statement by the patient indicates a need for further teaching?

Answer: 'I can go swimming in a pool 48 hours after my port is accessed.'

Swimming in a pool with an accessed port is contraindicated due to infection risk; the patient should avoid submerging the accessed site until the needle is removed and the site is fully healed.

When reviewing a care plan for a patient with a PICC receiving vesicant chemotherapy, the vascular access nurse should ensure which safeguard is in place?

Answer: Verify tip location via chest X-ray or fluoroscopy confirmation before initiating vesicant infusion

Radiographic confirmation of correct catheter tip position at the cavoatrial junction is mandatory before administering vesicant agents to prevent catastrophic extravasation into surrounding tissue.

A patient with obesity (BMI 42) requires peripheral IV access. Ultrasound reveals the basilic vein at a depth of 1.5 cm with a diameter of 5 mm. What is the appropriate catheter selection?

Answer: 20-gauge, 1.88-inch or longer catheter to ensure adequate intravascular length

When vein depth exceeds 0.5 cm, a longer catheter (≥1.88 inches) is needed to ensure sufficient intravascular dwell length and prevent dislodgement in patients with obesity.