VA-BC CERTIFICATION / VA-BC EXAMS / VA-BC
STUDY GUIDE 2023-2024 ACTUAL EXAM 400
QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES GRADED A+
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What are the indications for a midline catheter? - -Infusions projected for 6 days- 4 weeks
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
What are contraindications for a midline? - -Arms with: A/V fistula, infection, fracture, trauma, or compromised circulation
-Chronic Kidney Disease
What are the sites and vessel selection for midline catheters? - Basilic or cephalic vein in the antecubital fossa or lower part of the upper arm
What product should be used for a midline placement? - A product that is specifically designed and labeled as a peripheral midline catheter
What barrier precautions should be considered for midline placement? - Maximun sterile barrer
Why should a PICC device NOT be used for midline placement? - Using a PICC device for midline placement will risk confusion related to the type of access device a patient has; places the catheter tip outside the SVC, which is contrary to the manufacturers' DFU related to the intention of the product and risks potential liability for the nurse.
What is optimal tip location for a midline catheter? - One inch below the axillary area
For midline placement, what alternative veins can be considered in pediatric patients? - Scalp veins
Popliteal veins
Saphenous veins
What are the indications for non-tunneled catheters? - Short term central vein access
Emergency central vein access
What are the contraindications for non-tunneled catheters? - Neck or chest sites may be excluded for patients with tracheostomies, radical neck dissection, and cervical fracture instability, or unstable airway
Inability to position patient, insert or stabilize catheter
Avoid insertion on same side as a PICC that passes through the subclavian vein
What are the potential vessels for non-tunneled catheters? - A. Jugular veins, external and/or internal B. Subclavian veins
C. Femoral veins (least preferred)
In patients at greater risk for catheter associated bloodstream infections (CABSI) what typed of PICC or non-tunneled catheters should be considered? - Anti-microbial catheters
What type of barrier precautions are required for non-tunneled catheter placement? - Maximun sterile
How should a patient be positioned for non-tunneled catheter placement? - slight Trendelenburg position
Why is a patient placed in slight Trendelenburg position for non-tunneled catheter placement? - to avoid the possibility of air emboli during the placement procedure
In non-tunneled catheter or PICC placement., what should always be avoided when accessing veins? - Blind-stick attempts.
Prior to any infusion of non-tunneled catheters, how should tip location be confirmed? - ECG technology or radiograph
What must be obtained prior to ANY infusion of a non-tunneled catheter or a PICC line? - A free flowing blood return
What is the optimal tip location for a non-tunneled and PICC catheters? - Cavoatrial juncture (CAJ)
If inserted through the femoral vein, what the optimal tip location for a non-tunneled and PICC catheters? - Inferior vena cava (IVC) above the level of the diaphragm
Why is the femoral vein is commonly used in pediatric critical care units for nontunneled catheter placement? - Due to ease of insertion in young patients
Why may the jugular vein be the preferred point of insertion in very young children for non-tunneled catheters? - To avoid a pneumothorax
What are the indications for placement of a PICC line? - -Patients who require central venous access when the duration of the infusions are unknown
-Infusion of irritating medications
-Infusion of vesicant agents
List indications for Vascular Access: - 1. Total parenteral nutrition (TPN)
2. Partial parenteral nutrition
3. I.V. fluids and medications [Show Less]