Assignment: Acute Care Nurse Practitioner

Assignment: Acute Care Nurse Practitioner

Assignment: Acute Care Nurse Practitioner

Preparatory Work

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Learner: Date:
E-mail: Cohort:

Instructions: Complete one form for each of the following prior to your assigned skill day:

  1. Suturing
  2. Wound debridement/incision and drainage
  3. Arterial line insertion
  4. Central venous catheter insertion
  5. Chest tube insertion
  6. Intubation
  7. Lumbar puncture
Skill: Arterial Line Insertion
Pertinent anatomy: The procedure can be carried out on arteries in the extremities and neck. Examples are the radial artery, ulnar artery, femoral artery, axillary artery, brachial artery, dorsalis pedis artery, posterior tibial artery, and superficial temporal artery (Wiegand, 2017). The radial artery is the most common insertion site for the arterial line. In the few days in the postnatal period, the umbilical artery has clinical value in arterial access
Indications: ·         Arterial line insertion is mostly done in critical care settings where Real-time serial blood pressure monitoring is indicated. This method offers a continuous beat-to-beat assessment of blood pressure.

·         Intensive care unit patients who are unstable and require inotropic support require this procedure.

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·         Patients requiring frequent arterial blood gas analysis benefit from onetime arterial line insertion.

·         In situations where noninvasive blood pressure is not readily available, an arterial line can be used (Wiegand, 2017).

·         For patients receiving vasoactive medications, reliable titration can be assisted by arterial line insertion.

·         Patients in shock of any type require continuous monitoring

·         Patients in cardiac arrest, those that require ventilatory support, or those under intraaortic balloon pump therapy may require arterial line (Wiegand, 2017).

Contraindications/ Special considerations: ·         Vascular insufficiency in the peripheral and distal arteries

·         Peripheral artery disease  

·         Absence of collateral circulation. For example, patient variants with no ulnar artery should not receive a radial arterial line. Therefore, Allen’s test should be done before the procedure (Wiegand, 2017).

·         Active infection at the site of line insertion prevents the use of that site for line insertion. Caution is also taken with patients on anticoagulation theory

Complications: ·         Thrombosis is the most common complication

·         Embolization can result from thrombosis

·         Bleeding can result from the insertion site or when the line dislodges

·         Bleeding can lead to hematoma. This is common when the femoral artery is used (Wiegand, 2017).

·         Infection can result from skin flora or other ports of entry. Bacteremia is a feared complication.

Reviewed videos and text: ___X_Yes 

 References

Wiegand, D. J. L. M. (2017). AACN procedure manual for critical care (7th ed.). Elsevier. ISBN-13:9780323376624

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ANP-635CE – Acute Care Nurse Practitioner
Preparatory Work
Learner: Date:
E-mail: Cohort:
Instructions: Complete one form for each of the following prior tobefore your assigned skill day:
1. Suturing
2. Wound debridement/incision and drainage
3. Arterial line insertion
4. Central venous catheter insertion
5. Chest tube insertion
6. Intubation
7. Lumbar puncture
Skill:
Pertinent anatomy:
Indications:
Contraindications/ Special considerations:

Complications:
Reviewed videos and text: ____Yes ____ No

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Assignment: Acute Care Nurse Practitioner

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