Author Question: The patient is expected to require intravenous therapy for several years as treatment for a chronic ... (Read 136 times)

WWatsford · **on:** Jun 25, 2018

The patient is expected to require intravenous therapy for several years as treatment for a chronic disease process. Which of the following would be the best choice for venous access in this patient?

a. Peripherally inserted central catheter (PICC)
b. Nontunneled percutaneous central venous catheter
c. Subcutaneous implanted port
d. Peripheral IV

Question 2

Appropriate intervention for the patient who is having a reinfusion of chest tube drainage is noted when the nurse:

a. Hangs the reinfusion lower than the usual intravenous (IV) bag
b. Uses a microaggregate filter on the reinfusion bag
c. Maintains 500 mm Hg pressure in the gravity blood cuff
d. Keeps the clamps open on the drainage tubing during bag transfer

adammoses97 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

C
Implanted infusion ports are used for long-term and complex IV therapy. When not in use, no external catheter is present, and port manufacturers recommend that the port be heparinized every 4 weeks to maintain patency. No other care is required for an unused port. PICCs provide alternative IV access when the patient requires intermediate-length venous access (>7 days to several months). These catheters are used for shorter placements (e.g., 5 to 10 days). Use of peripheral IV therapy increases the risk for patients to develop infection, vein sclerosis, phlebitis, and infiltration.

Answer to Question 2

B
Use a new microaggregate filter to reinfuse each autotransfusion bag. Hang the bag on an IV pole and continue to prime the tubing until all air is gone. Clamp the tubing, attach it to the patient's IV access, and adjust the clamp to deliver the reinfusion at the appropriate rate. Reinfusion is delivered by gravity or by application of a blood cuff (not to exceed 150 mm Hg pressure) or a blood-compatible IV pump. Connect the red and blue connectors on top of the initial collection bag, and remove it by lifting it from the side hook and then from the foot hook. This maintains a closed system within the bag and removes it for use in autotransfusion.