The ICU patient requiring high doses of Propofol and Fentanyl for ventilator synchronization.
A Med Surge patient on day 4 of an ileus who is starting TPN this evening
A 72 year older cancer survivor post chemotherapy receiving IV antibiotics for a UTI
A 39 year old male who is detoxing from ETOH and has pulled out 3 IVs in the last 16 hours
Central line dressings that are covered with a clear occlusive dressing and no gauze are changed?
Every 7 days
Monday nights
Every 5 days
Only when visibly soiled
The provider has ordered 3% Saline for your patient. After confirming the order and level of care appropriate for the patient the best response is to?
Obtain an order for Stat central line insertion
Do not delay care and infuse through a 20g IV in the antecubital
Do not delay care and infuse though any functional IV
Which patient would not be a candidate for a central line?
An 84 year old male here after a fall at home requiring multiple incompatible IV infusions with limited IV access.
A 27 year old female who is Septic from a UTI and suffering from Disseminated intravascular coagulation
A 76 year old female with urosepsis requiring vasopressor support
A 32 year old cancer survivor with poor peripheral access who needs IV antibiotics for his RLE cellulitis
You have received a patient transfer from CCC. The patient is here for sepsis caused by cellulitis. They have a PICC in the right arm that is infusing 0.9%NS at 83ml/hr. They are receiving Vancomycin 1000mg q12hr. Please select the best option.
Keep the PICC line in place since the patient is a fresh ICU transfer and was on Levophed yesterday.
Vancomycin is caustic when infiltrated and a central line should be used.
Attempt to obtain a peripheral IV and discuss discontinuation of the PICC with the provider.
PICC lines can remain in place for extended periods there is no need to address at this time.
When flushing a central line best practice is?
Use a 20cc syringe of 0.9%NA to ensure continued patency
Using a 10cc 0.9%NA flush 1ml at a time with brief pauses to get a turbulent flush ensuring patency
Using a 10cc 0.9%NA flush give a smooth continuous flush to avoid damaging the catheter and maintain patency.
Using a 5cc 0.9%NA flush push quickly to ensure patency