I'm struggling a bit with a few questions. The prof is known for poorly wording things, so I mostly want to see if other people read them/interpret the same way I do.......
1) What is the difference between a VAD with two ports and one with two lumens?
A VAD with two PORTS allows you to:
A) give incompatible IV fluids at the same time, each through a different port
B) give an incompatible IV push med when the other line is clamped and flushed.
2) A central line has a HIGHER risk than a peripheral line for:
Air embolus - true/false?
Site infection/sepsis - true/false?
Losing large amounts of blood if the line is left open - true/false?
3) if a patient with cellular dehydration is given D5W, will the intracellular fluid volume go up, down or stay the same?
That is all for now.... I'm just a bit confused and the prof won't clarify anything....
Nov 23, '11
1) what is the difference between a vad with two ports and one with two lumens?
well, that's sort of the main point, isn't it? your prof isn't being obscure here, she's asking if you know a straight definition.
a lumen is the tube that runs down to the end, or somewhere near the end, of the catheter. iv catheters can have one lumen, two, three, or (rarely) more. they are separate tubes-within-a-tube and their contents do not mix.
a port is the site outside the body where you can plug something in. a lumen can have two ports that both inject into the same lumen. generally a multi-lumen line has one port per lumen. now you should be able to figure out the next answer and give rationales.
a vad with two ports allows you to:
a) give incompatible iv fluids at the same time, each through a different port
b) give an incompatible iv push med when the other line is clamped and flushed.
2) a central line has a higher risk than a peripheral line for:
air embolus - true/false? depends. if she means, if the line is left open to air, it's true, because spontaneous inhalation will decrease intrathoracic pressure and suck air into the trachea and the open iv line (that's also a tube going into the chest). if she means, because somebody injects air into it, same; anybody can inject air into anything. if she means, a dangerous amount of air (as opposed to any old air bubble, which is an embolus too), it's true.
site infection/sepsis - true/false? site skin infection, no difference at the site. sepsis is, well, sepsis (this means more than just "local infection"), but an infected central line insertion site can develop a worse problem a lot faster than an infected peripheral one (you'd find the peripheral one's problem first).
losing large amounts of blood if the line is left open - true/false? also depends on patient anticoagulation, position of the site relative to the vena cava (a unplugged peripheral iv in a forearm dangling over the edge of the bed can put out an astonishing amount of blood), central venous pressure; but generally, a central line is larger in caliber than a peripheral line, so it will carry larger amounts of blood and not clot off as easily, either.
3) if a patient with cellular dehydration is given d5w, will the intracellular fluid volume go up, down or stay the same? aha, that's a straightforward do-you-know-your-permeability-and-fluids-osmolarity-physiology lesson question, not tricky at all if you learned that very basic material. go try again to look up the osmolarty of iv fluids, what that means, and how fluids distribute intracellularly and extracellularly, and ask again if you can't figure it out from there.
Last edit by nurseprnRN on Nov 23, '11