VA-BC Certification Study Material new material guide.
List indications for Vascular Access:
1. Total parenteral nutrition (TPN)
2. Partial parenteral nutrition
3. I.V. fluids and medications
4. Blood and blood components
5. Chemotherapeutic agents
6. Cardiac monitoring
7. Plasmapheresis
8. Aquapherisis
9. Hemodialysis
a. Diagnostic testing
b. Frequent blood sampling
What is the French Scale?
Measurement of the outside size (diameter) of a catheter
What is the range of Central venous catheter French sizes?
1.2fr for Neonates up to 15fr for dialysis catheters
As the French size increases, what does the diameter of the catheter do?
It increases
What is the gauge scale?
Measurement of the outside size(diameter) of a catheter
As the gauge number gets larger, what happens to the catheter size?
It gets smaller.
What is the gauge range of IV catheters?
24ga to 12 ga
Why are all I.V. devices manufactured in the USA are required to be radiopaque?
To facilitate location of catheter emboli in the event of shearing or fracture
From what two materials are IV catheters made?
Silicone and Polyurethane
Which catheter material can be affected by alcohol?
Polyurethane
What are the indications for short peripheral catheters?
-Infusions projected for 6 days or less
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
, What are contraindications for short peripheral catheters?
-Placement into an arm with fracture, trauma, infection, or compromised circulation
-Veins in the arm on the same side of a mastectomy, breast surgery or lymph node
dissection
-Veins in the arm with an A/V fistula or graft
What veins are used for short peripheral catheters?
Metacarpal, cephalic, basilic and accessory veins of the arms
How many short peripheral catheter insertion attempts per healthcare provider
are allowed?
2
What additional veins in pediatrics may be used for non-irritating/non-vesicant
infusions?
Metacarpal, cephalic or basilic, scalp veins if <18mo
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
List indications for Vascular Access:
1. Total parenteral nutrition (TPN)
2. Partial parenteral nutrition
3. I.V. fluids and medications
4. Blood and blood components
5. Chemotherapeutic agents
6. Cardiac monitoring
7. Plasmapheresis
8. Aquapherisis
9. Hemodialysis
a. Diagnostic testing
b. Frequent blood sampling
What is the French Scale?
Measurement of the outside size (diameter) of a catheter
What is the range of Central venous catheter French sizes?
1.2fr for Neonates up to 15fr for dialysis catheters
As the French size increases, what does the diameter of the catheter do?
It increases
What is the gauge scale?
Measurement of the outside size(diameter) of a catheter
As the gauge number gets larger, what happens to the catheter size?
It gets smaller.
What is the gauge range of IV catheters?
24ga to 12 ga
Why are all I.V. devices manufactured in the USA are required to be radiopaque?
To facilitate location of catheter emboli in the event of shearing or fracture
From what two materials are IV catheters made?
Silicone and Polyurethane
Which catheter material can be affected by alcohol?
Polyurethane
What are the indications for short peripheral catheters?
-Infusions projected for 6 days or less
-Non-irritating medications and solutions
-Non-vesicant medications and solutions
, What are contraindications for short peripheral catheters?
-Placement into an arm with fracture, trauma, infection, or compromised circulation
-Veins in the arm on the same side of a mastectomy, breast surgery or lymph node
dissection
-Veins in the arm with an A/V fistula or graft
What veins are used for short peripheral catheters?
Metacarpal, cephalic, basilic and accessory veins of the arms
How many short peripheral catheter insertion attempts per healthcare provider
are allowed?
2
What additional veins in pediatrics may be used for non-irritating/non-vesicant
infusions?
Metacarpal, cephalic or basilic, scalp veins if <18mo
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
