" I.V. Therapy Demystified
11>< n" ... gen'ly "''''''' .. " ,he dre .. ing. o"",fully lining it from ,be in",nion .;Ie 50 as 001 to di<lodge tt.. c,,"'Ie,.
n.e
;.""rtion .i .. and <.the"" are in,pected fo< .ny evideoce of drifting,<""'king. infection. Of p/llebiti,.
n.e
nu,,", remo',,,, lhe IlOIISIeriIe glo,-", and doo. the storile glo,-e>.n.e
.ite i. ole.nsed ,,-ith .Irobol .wab. from ,he <enter of the ;"",nion .it.ou, .. "2Ill "'ing > <ircular mo<ion. n..lioe ,Ilen i. dean",d willi an .lcohol .".b from the insen,OII ,ite to the end. If .. lIu, . . are
pre"'"'.
,hey ore .1", cleansed with alcohol.n.e
.kobol i •• I""'ro to dry.11>< .i,o
,he"
i. cleansed with povidone_iodine .wID. "'ing (he """'"tochnOq"" ., describOO previo .... ly fa" cle"".ing
,,'i'"
.Icobol .wab •.n..
.ite is dr .... d per "S"OC)' Of hospital policy using .itber • lI"uz.e d", .. ing or • lnUI'J>af"n' ><mipe""".ble membrane, If. gouze dre .. ing i. used. the ."... of the d", .. ing must be ",>led rompletoly with tape Of •tr=parent oemipem .. ,.Me meml>r.me.
n.e
<ble and time lhat the dre .. ing ,",'as ch2ngoo. the gauge .od length of the c.lI>e1 .. i"5ef1..t. and initials of nune ,,'he performed tbe dressing change .... written in ink 011 the dre .. ing label.11>< procedure i. documented appropriately in tbe patient". record,'
1here are some octivity .nd proceW",1 re>lrictions tIIat patients ... kl be cautioned to adhere to 1""""'" functioo of tbe
Pia::
fC4" the Iooge" time p""ible. Blood pre»<>re reading • .00 ,'enip'lIl<1w<o> ... Id DOt be pcmtined 011 tbe """ that 1= the PICC line. Patients ","51 be c ... tioned DOt to get the Pice dre>.>.ing wet 0< diny.Dr ... inS' should be ro",,,,d with. prot""ti...., banier ,,'ben patients take ... "" 50 thai they co""", gel wet 01 O!herwisoo ""'t2minated. Activities like"i .. should be
",>Iricted that cook! either d:omage the cadr"', 0< c ... the calbctcr to drift. n..".
include lifting of objects ",.ighing nx>re than 10 poonm ond any orn:,'ities thai migt-.
entail r"p''''lod u .. of the """ 01 thai mighl cau", the el_' to fie> repeatedly.
CHAPTER 5 Centralintravenou$ Therapy
"",h .. mne prxb,ionc'r>, " _ mid",·,,~. "u ... and phy>ician
..wunu ...
1>0 hove ,he ".,IIo<'ly 10 do 00 by tht" fUptt",.. ... ,. _ of mood .. ",. and " ... i .... Pot"'n .. """""" ....""IaVtall
uiusul>< ... _
ocrr....J diftctty by crn<r.d 0 ... hove 1hc:'s/lttflC'd n'"
ol~. pn<1ImoIbonx . .... omboIi>m. do .. ,"""' .. and .nf""' .... •C .... r.dly .n...nod I.V 1._ !ftCiudo 1tJ<I . . 1od""""", and .mpllUIUWo pons. T...,1cd atb<tcr> .... 00 . . mood b«... !hoy .... O«'....d
throup •
surpcoIly oru ... _ _ ... 1 IbM tht <aIhtIet "".-..-bet"'ftfI h ... OIl tho d .... "-,,IL ')-pocoIly bet,, __ tho ... and 1 .. ppk. and tho vnn. typi<olly tho _b,-ion ... T ... 1cd C1IIIItIcD .... " •• ain 0<CeU-.... t.t>bil~y
Ionr
and OR aoooci2ted ,,;ttI omoIlcJ.-. '" .. f«1>Oll.t..o _ _ ltd ... ~ .... ,"n
-o""., ....
fnll"'"o..:roa ""If.
til tho "-,,II .. II ... hat ... , _ _ by • cuff'" Ii_
6 ... Tho. ~_ " ... _ _ tht d...!r...,...
of pnw1di~ Ii<><.oabil~y - ' p"",id,"Io borner IbM .. <fillia,,' fu ~ to ... and ttl ...
tb, •
.-oru
tho ... hom p'n'~""-oo tho ... I .. tn."I~ poru "'" inoMcd ... thai poII<'nli "'")' ....,.",.. iNrnninrn,
~ of d""_,,,~,,,,
irfeI\I"
bIo>d "" ... .,Mo.. and~ ... nutrirn ..OWl' --.no! montho.
n.c..
poru 1100'*' ...
fu ",'iIhdra",-"I ol blood sp<ei ... I'ob< .... ,,-loa ho,.. ,mplalllabIo poru f~dy ho ... OOll<ft and ..., up«Wd Ie> ~ ... ...,...., - . . of~. Often tho.., poli<tH 0100"""" wtbmj, blood sp<e' .... n' 00 thai ... 11> from iab<nI<o<)' ona1y.=,,'" be...J Ie>
guid< th<npy, Blood sp<e, .... '"
may
be",lMno .. ."
readily from tho 1""' ... vinS oicIr.pa6<nts from ","I"pi< "'ml"' ... So !hoi tho m'''''I"..' .... ot\ tht .. porIJi ... "'"
rupI.rM,O opeci'" ~"11IO<d1t o.11od 0 I/"~, ~tdl~" .«d. Figu'" 3.3 """"",.
~!-.l ...- _ _
.,.."._.1 _ _
"~. (FrIBs..- ....
~SJ._B.EmOL"'" ... &F.,.·.'· I ''''fN''''''r-lIIo«1-UP!'<' _x ... . ''',
Pt---..-lbIt 2OOI.I'Sl.)~~
..
~I.V. Therapy Demystified
a typic.1 implan .. bk port with . Huber ..""lIe,
n.e..
<Ie.ice. are insrned wOCu'''''''''''''ly on tile che" .... IL and the ",bda.i,n ".in i. the mo>I rom....ruy",Ie<.wd
,onoo. """""
.ite.P"", ... """."I)"
i"..ned"""lnl
o.th<tcr, may he in",n..t at the b.d,ide,n....
t),pe. of <00, ... 11. V. Ii""" mu" be i...,ned by. J>hy.ician Of by an adV>OCed_prxti.ce clinici.n ... de",ribed 1'"',;oo.ly.
n.e
nurse typic.lly ... iSl' d"ri"~ """" .",ril.procedure., and ,be equipment ,,"up i. >imilar to that "",d fOf insenioo of • PICC . .. de",ribed .arlier. The :oc<ur:a'" pl""e"","' of ,he .. Ii ... 1 ... mu" be ",rifie<! by .... y. bef"", oolu,iom can be infused .. roly. Figure ~-4I"""'n" '1<'0 illustr:ations of perc"'""""",ly in",ned cen,,,,1 c .. bel ...
There are "",oy differen' t),pe. of
"""",,I
><oou. <.!he .. , prod'"'« that <,n be .. 1","00 fC4" any g;.on patient, Some catheters haye multiple""""" pons or lume". ,hal may be u....t fOf infu.ing multiple 'ype' of solution •. Fi~ure 5_S """",.two rommoo type> of COl""""_ one ,,'ith •• inSIe lumen and another with a triple I""",n.
'"'gYr< 5·~ C",tr>I ... "". <><hel<t>. A Subdavian ~tn.1 V<'OOUS calMt<f. B. l"t<rnaI ju£1Jiaf c ... tn.1 ,-...,. c.u..t<f. (U>«l "'ilh penni"ion from BemwI A. Snyder Sl,
](ozief B. Erb GL: ~, .ti
Em' , F-'''''' of
N."u.~, 8th «l Upper S-addJ< Ri,·", Nl: Prnltice-Hall. 20011: 1~~7.)CHAPTER 5 Centralintravenou$ Therapy
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!.! c ... 1111 _ _cw ...
A. 510,".100""", II. TrIpIo.I"""" """""". ("rom" " _ SEc
v ... ""
AIT .... I""",~, <Md , _ _ , )!II 0fI" ~ll.ool" Mooby. '_71.)PolieDIS "'jlll cmlBll.¥' li ... ~ ma .. uaift....,; .. drew ... O"o'ff lhrir ><=OS
s.iLn _ .... the ... I~P<> '"
""';op
111M <OVef PICe I""";"" s.i ....n..
scbodule ODd lOch ...