varied medical questions...

fultzymom · Jan 17, 2008

1. Yes at my facility the protocol is per lumen if it is a multiple lumen cath. You want to make sure that all of them are flushed to keep them open, even if you are not using them all.

2. I have had PICC lines that I could not get blood withdraw but flushed fine and IV's flowed through fine.

3. I have only flushed with Sterile H2O. But I do not know if you can use NS or not. I guess it would depend what the doc wants. I have never heard of using NS but that does not mean I am right.

4. I thought that once you had a mastectomy you never used that limb again. Or at least that is how our policy states at my facility.

You can google wounds and find all kinds of websites that tell all about the stages and treatments. Hope this helps some.

classicdame, MSN, EdD · Jan 17, 2008

Infusion Nurses Society standards recommend twice the volume of the catheter (tubing) for flushing with a minimum of 2cc and ALWAYS with a 10cc syringe.

You may be able to flush but not aspirate if there is fibrin on the end of the cathlon sheath. This is a clot waiting to happen. We use a low-dose heparin like Cathflow to break the small clots and fibrin sheaths.

You can google for pressure ulcers or decubitus ulcers and get staging. The WOCN websites have them too. Medicare has not caught up to the new staging that was instituted last year. So deep tissue injuries are still Stage 1 to Medicare. This is a problem with documentation. The idea behind staging is to have everyone on the same page, but of course we are not.

Zookeeper3 · Jan 17, 2008

quote=edyrn;2607077]hello ..just got some questions that need answers and im pretty sure we all could learn from these:

1. how do we you flush a picc;our protocol says 10mls of ns and 2 mls of heparin.is that per port if i have 2 port picc? each port gets 10 mls ns then the heparin. please read policy.. get to work 15 minutes early.

2. if i dont have a backflow on a picc is it ok to use it(no resistance observe. how about if i dont have backflow and w resistance observe on one of the port,could i still use it?i hate this... how do you know?....if using a vesicant like dopamine... iv contrast... you can refuse to use and request an x-ray for placement if not done recently... its what a reasonable and prudent nurse would do.

3. how do u flush a indwelling foley w only 2 ports? one for the balloon and one for the drainage bag? and w what,sterile h20 or ns? leave the balloon alone unless it's leaking from the site, gather all sterile equipt. flush and sterile h20 (this is easier with 2 at first).. disconnect the drainage bag from the foley... keep all ends sterile, foley in non dominant hand and clamped by bending. dominant hand grabs the syringe full of sterile saline and infuses, then pulls back. do this several times with clots to dislodge them, keeping it all sterile. the clots will come back in the syringe... then one final flush... connect... urine will flow... if doing i&o, take off the fluid flushed in before reconnecting.... sterile!

4. how long should an extremity be no sticks,bp,etc if a pt has undergone mastectomy? go by your facility policy. not all masectomy have extensive lymph node resection (waste dumping and recirculating system). if 5 years have past and the patient is cancer free for 5 years and has no arm edema, the extremity is now free from risks. know your policy

5.if you know of a website that i can learn w staging of wound, please share.sorry, no

thanks for all the answers.if you have a ref book please indicate.

excellent questions, i had them myself. reference books are key, but please spend time in you policy books... they are the only reference to back you in a court of law. you really are responsible to know and adhere to the phone book of policys. it's overwhelming at first, keep at it and good luck. keep asking the good questions.

edyrn