Mixed Deck — All PICC Topics Flashcards
100 cards from real PICC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 20 Mixed Deck — All PICC Topics flashcards as text
What solution is used to flush PICC lines?
Answer: Normal saline or heparin
To maintain patency and prevent occlusion of PICC lines, they are routinely flushed with either normal saline or a dilute heparin solution. Normal saline is used to clear medication residue and prevent intraluminal clotting, while heparin, an anticoagulant, is often used for catheters that are not in continuous use to prevent thrombus formation within the lumen. The specific solution depends on facility policy and catheter type.
Which element is essential in a PICC education documentation form to meet Joint Commission standards?
Answer: Date, method of instruction, content covered, and patient's demonstrated understanding
Joint Commission requires documentation of the date, teaching method, content, and evidence of learner understanding.
During EKG-guided PICC tip confirmation, which waveform change indicates the tip has reached the cavoatrial junction?
Answer: The P-wave increases in amplitude, then becomes biphasic as the tip enters the right atrium, signaling slight withdrawal is needed
EKG guidance relies on P-wave changes: amplitude increases as the tip nears the SVC/atrial junction and becomes biphasic upon entering the right atrium, guiding the clinician to withdraw slightly to the CAJ.
What is a CLABSI?
Answer: Central Line-Associated Bloodstream Infection
CLABSI stands for Central Line-Associated Bloodstream Infection. This term refers to a serious infection that occurs when germs enter the bloodstream through a central line, such as a PICC. CLABSIs are a major concern in healthcare due to their potential for severe patient outcomes and are a key indicator of healthcare quality and safety.
The azygos vein, into which a PICC can malposition, enters the SVC at approximately which vertebral level?
Answer: T4
The azygos vein arches over the right main bronchus and drains into the posterior aspect of the SVC at approximately the T4 vertebral level.
When a PICC professional encounters an unexpected result during a procedure, the FIRST action should be to:
Answer: Stop, assess the situation, and determine whether to proceed or seek guidance
Stopping to assess unexpected results is critical for safety and quality.
What is the minimum recommended saline flush volume for a PICC after each use per INS guidelines?
Answer: 10 mL
A minimum of 10 mL of normal saline is recommended to flush PICCs after each use to clear the long lumen of blood and medication residue.
A nurse documents a PICC line with 'sluggish blood return but no resistance to flush.' Which intervention is most appropriate per INS standards?
Answer: Assess for fibrin sheath and consider alteplase per protocol
Sluggish blood return suggests early fibrin formation, and per INS standards the nurse should assess for fibrin sheath and initiate thrombolytic therapy per institutional protocol.
Which patient position is recommended during PICC removal to reduce air embolism risk?
Answer: Trendelenburg or supine with Valsalva maneuver
Supine or Trendelenburg positioning with Valsalva increases intrathoracic pressure, reducing the pressure gradient that could draw air into the vein during catheter removal.
Which PICC maintenance practice has been shown to reduce the risk of catheter occlusion AND infection simultaneously?
Answer: Scrubbing the needleless connector for ≥15 seconds with 70% alcohol before each access
Vigorous mechanical scrub of needleless connectors with 70% alcohol for ≥15 seconds (scrub-the-hub) prevents microbial contamination and reduces both CLABSI and occlusion risk.
How frequently should ongoing assessments be conducted in Peripherally Inserted Central Catheter Certified Nurse practice?
Answer: At regular intervals and as conditions change
Ongoing assessments should follow established protocols and also respond to changing conditions.
How should Peripherally Inserted Central Catheter Certified Nurse professionals handle procedures that have been updated or revised?
Answer: Review updates, complete required training, and implement revised procedures
Professionals must review changes, complete training, and implement revised procedures.
Which activity restriction should be documented in the patient's education record regarding PICC care at home?
Answer: Avoiding submersion of the PICC site in water such as pools or baths
Submersion in water (pools, hot tubs, bathtubs) increases infection risk and is a key home-care restriction to document.
Which layer lines the inner surface of veins?
Answer: Endothelium
The endothelium is the specialized epithelial tissue that forms the innermost lining of all blood vessels, including veins. This smooth, non-thrombogenic surface is crucial for preventing blood clots and facilitating the smooth flow of blood. It is the direct layer in contact with the blood within the vein.
A PICC line alarm indicates occlusion during a continuous infusion. After repositioning the patient, resistance persists. What is the next appropriate step?
Answer: Attempt to aspirate and assess for blood return, then consider thrombolytic therapy
If repositioning does not resolve the occlusion, the nurse should attempt aspiration to assess patency and then follow institutional protocol for thrombolytic therapy if indicated.
Which assessment method provides the MOST reliable data for PICC professionals making critical decisions?
Answer: Standardized tools combined with professional observation
Combining standardized tools with professional observation provides the most comprehensive data.
In PICC practice, what happens when regulations are updated?
Answer: Professionals must update knowledge and practices to meet new requirements
All professionals must update their knowledge and practices when regulations change.
Why use ultrasound during insertion?
Answer: Visualize and guide vein access
Ultrasound guidance is a critical tool during PICC insertion as it allows the clinician to visualize the target vein in real-time. This visualization helps in identifying suitable veins, assessing their patency, and guiding the needle precisely into the vessel. Using ultrasound significantly increases insertion success rates and reduces the risk of complications like arterial puncture or nerve damage.
Which assessment method provides the MOST reliable data for PICC professionals making critical decisions?
Answer: Standardized tools combined with professional observation
Combining standardized tools with professional observation provides the most comprehensive data.
How to manage catheter occlusion?
Answer: Thrombolytic agent
Catheter occlusion, often caused by a thrombus (blood clot) within or around the catheter lumen, prevents proper flushing or aspiration. A thrombolytic agent, such as alteplase, is specifically designed to dissolve blood clots and restore patency to the catheter. This targeted treatment is more effective than simple flushing for clot-related occlusions.