Pediatric Access Flashcards

A 5-year-old with sickle cell disease requires frequent IV access. Which vascular access strategy is MOST appropriate for long-term management?

Answer: Implanted venous port to preserve peripheral veins

An implanted venous port is preferred for patients with sickle cell disease requiring frequent IV access because it preserves peripheral veins and reduces infection risk with proper care.

When performing a dressing change on a pediatric PICC, the nurse notes the exit site has a small amount of dried blood and no redness. The MOST appropriate action is:

Answer: Cleanse with chlorhexidine gluconate, apply a new dressing, and document

Dried blood at a PICC exit site without signs of infection is a normal finding; the site should be cleansed with chlorhexidine, redressed, and documented.

A 14-year-old athlete is hospitalized and requires IV antibiotics for 6 weeks. Which vascular access device is MOST appropriate?

Answer: PICC line for outpatient OPAT therapy

A PICC line is the device of choice for outpatient parenteral antibiotic therapy (OPAT) lasting weeks, allowing the patient to complete treatment at home.

In a pediatric patient with a tunneled CVC, the nurse notes the cuff is visible outside the exit site. This finding indicates:

Answer: Catheter migration that requires provider notification and evaluation

A visible cuff means the catheter has migrated outward; the provider must be notified because the cuff no longer provides the antibacterial and anchoring barrier it is designed to create.

Which strategy is MOST effective in reducing peripherally inserted catheter-associated infections in the neonatal ICU?

Answer: Implementing a catheter bundle including hand hygiene, maximal sterile barriers, and CHG skin antisepsis

Evidence-based central line bundles incorporating hand hygiene, maximal sterile barriers, and appropriate skin antisepsis are the most effective strategy to prevent catheter-related infections in the NICU.

A pediatric patient's implanted port is accessed using a non-coring (Huber) needle. The nurse cannot aspirate blood return but the infusion runs freely. The BEST next action is:

Answer: Reposition the patient (arm raise, deep breath, position change) and retry aspiration

Positional maneuvers can dislodge a fibrin sheath or tip positional occlusion causing blood return failure; if unsuccessful, further evaluation such as contrast study may be needed.

Which age-appropriate pain scale is recommended for assessing procedural pain during IV insertion in a 3-year-old child who can communicate verbally?

Answer: FACES Pain Rating Scale (Wong-Baker)

The FACES Pain Rating Scale is validated for children 3 years and older who can communicate, using facial expressions to help the child self-report pain level.