Pediatric Access Flashcards

Which catheter-to-vein ratio is recommended to minimize thrombotic risk when selecting a PICC for a pediatric patient?

Answer: Catheter should occupy no more than 33% of the vein lumen

INS and AVA guidelines recommend the catheter occupy no more than 33% of the vein lumen to maintain adequate blood flow and reduce thrombosis risk.

A neonate receiving parenteral nutrition (PN) through a peripheral IV develops erythema, blistering, and skin breakdown at the site. This is MOST consistent with:

Answer: Extravasation with tissue necrosis risk

Blistering and skin breakdown following PN infusion indicate extravasation, which is a medical emergency in neonates due to high osmolarity causing tissue necrosis.

When teaching a parent to care for their child's peripherally inserted central catheter (PICC) at home, the nurse should instruct them to report which symptom IMMEDIATELY?

Answer: Fever greater than 38°C (100.4°F)

Fever greater than 38°C in a child with a PICC may indicate catheter-related bloodstream infection and requires immediate medical evaluation.

In premature neonates, which anatomical factor makes scalp veins an acceptable but secondary peripheral IV site?

Answer: Scalp veins are well-visualized and relatively immobile, aiding cannulation

Scalp veins are visible and relatively fixed against the skull, making them easier to cannulate in premature neonates when extremity veins are inaccessible.

Which osmolarity threshold for IV solutions generally requires central venous access rather than peripheral access in pediatric patients?

Answer: Greater than 900 mOsm/L

Solutions with osmolarity greater than 900 mOsm/L are typically required to be administered through central venous access to prevent peripheral vein damage.

A nurse uses ultrasound guidance for peripheral IV placement in a 7-year-old with difficult access. In the transverse (short-axis) view, the vein appears as:

Answer: A circular dark (anechoic) structure that compresses with pressure

In the transverse ultrasound view, veins appear as circular, anechoic (dark) structures that collapse easily with probe pressure, distinguishing them from arteries.

Following IO insertion in a pediatric patient, the nurse should confirm correct placement by which finding?

Answer: The needle stands upright without support and bone marrow can be aspirated

Correct IO placement is confirmed when the needle stands upright without support and bone marrow aspirate is obtained, confirming intramedullary position.