Maintenance & Troubleshooting of Vascular Access Devices Flashcards
7 cards from real VABC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Maintenance & Troubleshooting of Vascular Access Devices flashcards as text
A precipitate occlusion caused by calcium-phosphate incompatibility in a PICC is best treated with which agent?
Answer: 0.1N hydrochloric acid (HCl)
Calcium-phosphate precipitates are alkaline and dissolve in acidic solutions; 0.1N hydrochloric acid is the standard treatment for this type of non-thrombotic occlusion.
How long should alteplase (1 mg/mL) dwell in a catheter when treating a thrombotic occlusion, per standard protocol?
Answer: 30–60 minutes with reassessment up to 2 hours
Standard alteplase protocol calls for a 30–60 minute dwell time, with reassessment; if patency is not restored, a second dwell of up to 2 hours total may be used.
Which dressing type is preferred for CVAD insertion sites in adults without excessive perspiration or bleeding?
Answer: Transparent semipermeable membrane (TSM) dressing
TSM dressings allow continuous visualization of the insertion site, reduce infection risk, and require less frequent changes than gauze dressings.
A chlorhexidine-impregnated sponge dressing is indicated for which patient population according to CDC guidelines?
Answer: Adults with CVADs when the catheter-related bloodstream infection (CRBSI) rate is not decreasing despite standard precautions
CDC guidelines recommend chlorhexidine-impregnated dressings as an adjunct measure for adults when CRBSI rates remain elevated despite standard prevention bundles.
When changing a CVAD dressing, the nurse should cleanse the site with chlorhexidine gluconate (CHG) using which technique?
Answer: Friction scrub from insertion site outward with 30-second contact time
CHG requires a friction scrub moving from the insertion site outward, with at least 30 seconds of contact and full dry time to maximize antimicrobial effectiveness.
A patient with a tunneled CVC reports redness, warmth, and tenderness along the tunnel track. This presentation is MOST consistent with:
Answer: Tunnel infection
Inflammation and tenderness extending along the subcutaneous tunnel (more than 2 cm from the exit site) defines a tunnel infection, which typically requires catheter removal.
What is the MINIMUM volume of flush solution recommended to clear a standard PICC lumen after medication administration?
Answer: 10 mL
INS guidelines recommend a minimum of 10 mL of normal saline to flush CVADs after medication administration to ensure full delivery and prevent precipitation.