Pediatric Access Flashcards

When assessing a neonate for peripheral IV placement, which vein is considered the LAST resort due to risk of tissue necrosis?

Answer: Femoral vein

The femoral vein is a last-resort site in neonates because extravasation in this area can cause severe tissue necrosis and limb-threatening complications.

A 3-year-old requires a PICC line. The nurse measures from the insertion site to which landmark to estimate catheter tip position?

Answer: Manubriosternal junction (angle of Louis)

The manubriosternal junction (angle of Louis) is used as the external landmark to estimate the catheter tip position at the cavoatrial junction in pediatric PICC placement.

Which gauge peripheral IV catheter is most appropriate for a stable 6-month-old infant requiring maintenance fluids?

Answer: 24 gauge

A 24-gauge catheter is the most appropriate size for infants, as it fits the small caliber of infant veins while minimizing trauma.

In a pediatric patient, the MOST reliable indicator of IV infiltration is:

Answer: Swelling, pallor, and coolness at the insertion site

Swelling, pallor, and coolness are the most reliable clinical signs of infiltration because they reflect fluid accumulation in surrounding tissue.

An intraosseous (IO) needle is placed in a 2-year-old during cardiac arrest. Which is the preferred primary site?

Answer: Proximal tibia

The proximal tibia is the preferred primary IO site in children because it has a large, flat surface that is easy to palpate and access during resuscitation.

Which topical anesthetic agent has a maximum safe application time of 60 minutes for pediatric IV insertion preparation?

Answer: LMX4 (4% lidocaine)

LMX4 (4% liposomal lidocaine) achieves adequate analgesia in 30 minutes and has a maximum recommended application time of 60 minutes.

When calculating the maximum safe dose of normal saline flush for a 4 kg neonate, the nurse should use which principle?

Answer: Weight-based dosing, typically 1-3 mL per flush

Neonates require weight-based flush volumes (typically 1-3 mL) to prevent fluid overload, as their circulating volumes are very small.