NRSG 3323 Lecture Notes - Lecture 3: Central Venous Pressure, Parenteral Nutrition, Bacteremia
1 Dec 2017
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On assessment you note the patient"s iv site to be cool, pale and edematous. The medication you were infusing has an alkaline ph of 8. Central venous access device (cvad: terminal end lies in superior vena cava, multiple lumens (for incompatible medications with iv, uses. Chemotherapy: hemodynamic monitoring (cvp) central venous pressure near r atrium, blood sampling. Peripherally inserted central line (picc: inserted into a deep peripheral vein at antecubital space, inserted by certi ed nurses, provides long-term venous access, less infection & pneumothorax risk than other cvads, cxr con rms placement (chest x ray) Insertion of a nontunneled line: meticulous aseptic technique. Wide sterile eld: scrub w/ 2% chlorhexedine/gluconate, cvc impregnated w/ chlorhexidine based antiseptic, trendelenburg position for insertion, cover site w/ biopatch. Then use a transparent dressing or gauze. Tuesday, september 19, 2017: change dressing only if non occlusive, soiled or bloody.
