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What is everyone doing about drawing peaks and troughs? The lab does not draw from PICC lines so the RN has to do it. Jun 28, 2005.
What tube is a Vanco trough drawn in?
Red-top tube, lavender-top (K2- or K3- EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel.
Can labs be drawn from PICC line?
Frequent blood draws: PICC lines can be useful for drawing blood repeatedly, especially if you do not tolerate blood draws well yet require ongoing monitoring through blood tests.
Can you draw blood from a PICC with TPN?
Generally speaking you should not draw samples from a dedicated TPN lumen. If you have a single lumen PICC with TPN infusing you should perform a standard venipuncture. Always use syringes when drawing from a PICC as other devices are not recommended b/c pressure changes sometimes make it difficult to obtain specimens.
When should Vanco trough levels be drawn?
Trough: just before 4th dose of a new regimen (prior to 3rd dose for dosing intervals ≥ 24 hours or changing renal function) – Trough levels should be obtained within 30 minutes before the next scheduled dose. – Weekly vancomycin levels should be obtained for long-term vancomycin use with stable renal function. i.
Do you centrifuge Vanco trough?
Centrifuge to separate serum or plasma. Transport temperature: Refrigerated (preferred) or frozen.
How do you administer alteplase to a PICC line?
Doses of 1 to 2 mg injected into the lumen(s) of central venous catheters or PICC lines, allowed to dwell for 15 minutes to 4 hours, then removed by aspiration, have been reported effective in establishing patency. Instill 2 mg/2 ml into the dysfunctional catheter for 2 hours.
Do you have to stop TPN before drawing labs?
For most tests collected from adult patients on TPN, discontinuing the infusion for 2 to 3 minutes prior to blood collection should be adequate.
What is the recommended method of flushing a CVC?
Use an alcohol swab to clean the injection cap to be flushed. Rub the cap vigorously for 15 seconds, and allow it to dry. Hold the end of the catheter so it does not touch anything. Remove the cap from the cannula/needle and insert it into injection cap.
Do you flush PICC lines with Heparin?
You may also need to flush with a heparin solution after the saline. Heparin is a medicine that thins the blood. It helps prevent blood from clotting in and around the catheter.
What labs do you monitor for TPN?
Weight, complete blood count, electrolytes, and blood urea nitrogen should be monitored often (eg, daily for inpatients). Plasma glucose should be monitored every 6 hours until patients and glucose levels become stable. Fluid intake and output should be monitored continuously.
What labs does TPN affect?
Lab values include CBC, electrolytes, calcium, magnesium, phosphorus, potassium, glucose, albumin, BUN (blood urea nitrogen), creatinine, triglycerides, and transferrin. Most patients will be NPO.
How do you know if a blood sample is contaminated?
A sudden shift of 4-5 fL, in the absence of a recent transfusion, is another reliable indicator of IV fluid contamination. Drug levels drawn from IV lines should also be interpreted cautiously. Some drugs, such as cyclosporine, tacrolimus and vancomycin, are very hydrophobic and adhere to tubing.
What do you do when Vanco trough is high?
If the high trough level appears genuine, use the vancomycin dose adjustment calculator to obtain a new dosage regime. Consider omitting dose based on the level: – If vancomycin trough level is 20-25mg/L, give new dosage regime without omitting any doses. Take a level before the 4th new dose.
Why are Vanco troughs drawn?
Vancomycin blood levels are drawn at timed intervals to measure drug levels during treatment. Vancomycin has a narrow therapeutic index, which is the ratio between the toxic and effective dose of medication.
How do you take vancomycin 4 times a day?
Take the capsules exactly as your doctor tells you to. It is usual to take one (125 mg) capsule four times a day for 10-14 days. In serious infections, the dose could be as high as 500 mg four times a day for 10-14 days.
Does Vanco trough need to be spun?
Specimen Requirements Spin down within 4 hours of draw. Note: 1. Date and time of last dose and time of draw are required.
What color tube is CMP?
Green Tube/Plasma: Centrifuge after collection. Gold Tube/Serum: Allow blood to clot for 30 minutes in a vertical position and centrifuge within 2 hours.
What labs are needed for vancomycin?
Kidney function tests such as creatinine and creatinine urine or eGFR may be requested prior to the start of vancomycin therapy and at intervals, or as needed, to evaluate changes in kidney status.
Why do PICC lines stop drawing blood?
Excessive force could cause a flexible PICC to temporarily collapse and occlude the backflow of blood. On a peripheral vein, you could be pulling the vein wall over the catheter lumen as in this drawing.
Who can draw blood from a port?
Blood draws via implanted ports may be performed by RNs trained in implanted port care. 3. This procedure shall be done using sterile technique and a non-coring needle.
Do you aspirate before flushing a PICC line?
PICC lines are typically inserted into the antecubital fossa, and then threaded into central circulation. PICC lines are frequently flushed with heparin to maintain patency and therefore it is imperative to aspirate 5 ml of blood from the line prior to use.
Can Cathflo be used in a port?
Alteplase (Cathflo Activase; Genentech, USA), a recombinant tissue plasminogen activator produced by recombinant DNA technology, was used to restore the function of 50 occluded chest ports. Occlusion was defined as the inability to withdraw blood freely from the port, or the inability to flush the port easily.
How do you use Cathflo in a PICC line?
Inject the 2.2 mL of Sterile Water for Injection, USP, into the Cathflo Activase vial, directing the diluent stream into the powder. Slight foaming is not unusual; let the vial stand undisturbed to allow large bubbles to dissipate. Mix by gently swirling until the contents are completely dissolved.
What is Cath Flo?
Cathflo® Activase® (Alteplase) is indicated in adult and pediatric patients for the restoration of function to central venous access devices that have become occluded due to a blood clot.
