Ultrasound Guidance Flashcards

A nurse documents that a patient's basilic vein has 'posterior acoustic enhancement' on ultrasound. This artifact indicates:

Answer: The vein is fluid-filled and patent

Posterior acoustic enhancement is a classic artifact seen deep to fluid-filled structures like patent vessels, where sound passes through fluid with less attenuation, brightening the tissue behind.

When scanning for a target vein in a pediatric patient, which ultrasound probe type is preferred due to its small footprint?

Answer: Hockey-stick (micro-linear) probe

The hockey-stick (micro-linear) probe has a very small footprint ideal for pediatric patients and small scanning areas while maintaining high-frequency resolution.

During an ultrasound-guided vascular access procedure, the nurse aspirates bright red, pulsatile blood. The immediate next step is:

Answer: Apply firm sustained pressure for at least 5 minutes and reassess

Bright red pulsatile blood indicates inadvertent arterial puncture; the needle should be removed immediately and sustained pressure applied for at least 5 minutes to achieve hemostasis.

Which ultrasound maneuver helps differentiate a thrombosed vein from a lymph node during upper extremity vascular assessment?

Answer: Apply color Doppler to detect internal blood flow

Color Doppler can demonstrate internal blood flow within a vessel (even thrombosed portions may show flow), while lymph nodes typically show no central blood flow or only peripheral hilar flow.

A PICC nurse uses ultrasound to assess a patient's median cubital vein at the antecubital fossa. This vessel is generally NOT preferred for PICC insertion because:

Answer: It is too short and merges near the elbow joint, increasing dwell complications

The median cubital vein is short, superficial, and located over the elbow joint, making it prone to catheter kinking, dislodgement, and mechanical phlebitis with arm movement.

According to the INS and AVA guidelines, ultrasound guidance for peripheral IV insertion is considered the standard of care in which patient population?

Answer: Patients with a history of difficult access or two failed conventional attempts

INS and AVA guidelines recommend ultrasound guidance for patients with difficult vascular access (DIVA) or after two failed conventional cannulation attempts.

When storing the ultrasound machine after a vascular access procedure, which step is essential to prevent probe damage and maintain equipment longevity?

Answer: Clean the probe with an approved low-level disinfectant wipe and hang vertically

Probes should be cleaned with manufacturer-approved disinfectant wipes and stored hanging vertically or in a protective cradle to prevent cable damage and crystal misalignment.