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VACC VACC Vascular Access

DOMAIN CATEGORY I: Clinical Knowledge and Application

A. Device Assessment and Selection

1. Central venous access devices

2. Peripheral intravenous devices

3. Dialysis, apheresis and aquapheresis catheters

4. Intraosseous devices

5. Arterial catheters

6. Pulmonary artery catheters

7. Device characteristics (e.g., single versus multi-lumen devices, optimal insertion and tip location)

B. Patient Assessment

1. Vascular pathology (e.g., impact of disease processes on vascular access)

2. Device selection (e.g., infusion therapy, alternative to IV placement, vesicants and osmolality)

3. Patient specific characteristics (e.g., compromised skin integrity, product reaction) and resources to maintain vascular access devices

4. Imaging technology (e.g., ultrasound, transillumination, fluoroscopy / venogram, chest x-ray)

C. Preparation

1. Infection prevention procedures, concepts and principles (e.g., sterile field, aseptic non-touch technique [ANTT], common pathogens)

2. Anatomy and physiology

3. Growth and development implications

DOMAIN CATEGORY I (continued): Clinical Knowledge and Application

D. Insertion

1. Vascular access device and insertion components

2. Insertion techniques (e.g., Modified Seldinger)

3. Flushing and locking solutions / procedures

4. Imaging technology (e.g., ultrasound, infra-red, transillumination)

5. Laboratory values relevant to device placement and maintenance

6. Tip location and confirmation systems

7. Engineered securement devices

8. Complications and emergency interventions (e.g., inadvertent arterial puncture, pneumothorax, catheter tip malposition, nerve injury)

E. Care and Maintenance of Vascular Access

1. Insertion / exit site assessment

2. Lumen patency and catheter clearance (e.g., flushing protocol, occlusion therapy)

3. Infusion equipment and add-on supplies (e.g., needleless connector)

4. Dressing change procedure

5. Patient / caregiver education

6. Care plan throughout the healthcare continuum (e.g., catheter insertion information, care and maintenance instructions, patient restrictions)

7. Vascular access device removal (e.g., removal length of PICC, removal complications, patient tolerance of removal procedure)

F. Troubleshooting, Complications, and Interventions

1. Post-insertion risks and complications (e.g., extravasation, thrombosis, infection, catheter tip migration, occlusion, nerve damage, phlebitis)

2. Pharmacologic interventions (e.g., catheter clearance, antibiotic lock, ethanol lock, extravasation treatment)

3. Catheter repair / exchange

4. Other complications (e.g., central vein occlusion, internal fracture, compromised skin integrity)

DOMAIN CATEGORY II: Interpersonal and Communication Skills

A. Interpersonal Communication

1. Communication with patient / caregiver (e.g., risks, benefits and alternatives; device care; infection prevention)

2. Communication with patient / caregiver with additional needs (e.g., developmental/ cognitive deficit, psychosocial concerns)

3. Cultural competency (e.g., cultural and religious differences, family involvement, language barrier)

4. Collaboration with patient's care team

B. Mentoring and education

1. Educational / staff development opportunities (e.g., quality improvement, hospital committees, early assessment for vessel preservation)

2. Infection control measures and techniques

DOMAIN CATEGORY III: Professional Development

A. Evidence-based Practice and Continuing Education

1. Evidence-based practice guidelines (e.g., AVA, INS, MAGIC, KDOQI, ACCP, SHEA)

2. Process improvement initiatives and outcome evaluation (e.g., implementation of new techniques and / or products)

3. Professional practice and development (e.g., seminars, webinars, conferences, certification)

4. Critical analysis of published research (e.g., research methodologies)

DOMAIN CATEGORY IV: Legal and Ethical Considerations

A. Legal Considerations

1. Professional codes of conduct, professional guidelines, scope of practice and standards of care

2. Legal principles in the practice of vascular access (e.g., consent, liability, HIPAA)

3. Documentation requirements

4. Manufacturer's guidelines for product use (e.g., Instructions for Use [IFUs], expiration dates, off-label use)

B. Ethical Considerations

1. Patient advocacy (e.g., patient preferences, end of life care)

2. Reporting requirements (e.g., MAUDE database, Joint Commission [JC], state health department)

3. Fiscal responsibility (e.g., accurate recording of charges, use of supplies and equipment, use of time)
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Question: 75
The nurse is gathering equipment for an arterial puncture. She has gathered the
following equipment: heparin solution of 1,000 IU per ml, sterile gauze, betadine
wipes, sterile needle, and syringe. What has the nurse forgotten?
A. Container of ice water.
B. Alcohol wipes.
C. Tourniquet.
D. Requisition form.
Answer: A
The urse has forgotten to gather a container for ice water. An arterial blood
sample is placed in a container of ice water to keep blood gasses from escaping.
The trial should be transported to the lab in the container of ice water and
analyzed within ten minutes of being collected. A tourniquet is not required for
arterial punctures, because of arterial pressure. Tincture of iodine is used to
cleanse the puncture site.
Question: 76
The nurse is aware that their hospital has a policy that allows nursing aides to
remove intravenous lines while on the surgical unit. The nurse delegates this task
to the aide and the intravenous catheter is removed incorrectly. Who is
responsible for this mistake?
A. The hospital, because the policy allowed the procedure.
B. The nurse, because they supervised the procedure.
C. The aide, because they performed the procedure.
D. Both B and C
Answer: B
In this situation, the nurse is responsible for the aide’s actions, because they
supervised the procedure. Tasks delegated to unlicensed personnel are ultimately
the responsibility of the nurse. Although the hospital may have a policy allowing
unlicensed personnel to perform certain tasks, this cannot override the state’s
nurse practice act.
Question: 77
The nurse is preparing to insert an intravenous catheter to administer fluids for a
patient who will have surgery. What is the most important factor that affects the
nurse’s choice of location for this site?
A. The type of cannula to be used
B. The duration of the infusion
C. The condition of the vein for use
D. Both B and C
Answer: D
When preparing to insert a catheter for intravenous fluids during surgery, factors
that influence the site location choice include the infusion duration and the
condition of the vein for use. An infusion that will run over a long period requires
a vein that will tolerate the instillation of large amounts of fluid over time, rather
than a short injection of fluid or medication. Additionally, veins that are in poor
condition may be difficult to cannulate and may not tolerate a fluid infusion.
Question: 78
What special precaution should be observed when collecting a specimen for blood
cultures?
A. Maintaining aseptic technique.
B. Maintaining postural position.
C. Maintaining calmness.
Answer: A
A special precaution when collecting a specimen for blood cultures is
establishing and maintaining aseptic technique during the collection process.
Bacteria are found on the skin surface and are considered normal. Without using
special precautions, the normal skin bacteria may contaminate the specimen. The
puncture site and rubber stopper on collection bottles are prepared using tincture
of iodine. After area has been prepared, the nurse should take care not to
contaminate the site by inadvertently touching or allowing the tourniquet to touch
the area.
Question: 79
A patient is admitted with severe burns over 50 percent of their body. The nurse
inserts an IV to begin fluid administration and for medications. What is the
typical process of fluid shift for this type of patient within the first 48 hours?
A. Fluid is pulled out of the blood vessels and into the tissues.
B. Fluid is pulled out of the tissues and into the blood vessels.
C. Fluid maintains equilibrium between the blood vessels and the tissues.
D. Fluid movement depends on the type of burn and the patient’s electrolyte
status.
Answer: A
During the first 48 hours following a burn, fluid is pulled out of the blood vessels
and into the tissues. The nurse must administer adequate fluids to prevent
hypovolemia and subsequent hypotension. The tissues will swell with the excess
fluid, but after approximately two to three days, the shift reverses and the fluid
returns to circulation.
Question: 80
Which statement is a requirement when managing exposure to blood borne
pathogens?
A. Nurses should receive training in handling occupational exposure if there is a
risk of coming in contact with blood borne pathogens.
B. Food and drink should be kept on a separate table in the operating suite, away
from the patient.
C. A contaminated needle should be carefully recapped before placing it in a
biohazard container.
D. Employers are required to provide measures for hand hygiene practices.
Answer: D
Employers are required to provide measures for hand hygiene practices. If
employees are expected to wash their hands to protect themselves from blood
borne pathogens, employers are mandated to provide materials for them,
according to the Occupational Safety and Health Administration. Food and drink
should be separate from operative procedures and not in the same room, and
contaminated needles should never be recapped to reduce risk of injury. All
healthcare personnel should receive training on exposure to blood borne
pathogens.
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Medical Vascular helper - BingNews https://killexams.com/pass4sure/exam-detail/VACC Search results Medical Vascular helper - BingNews https://killexams.com/pass4sure/exam-detail/VACC https://killexams.com/exam_list/Medical 901 Vascular PAD No result found, try new keyword!Seen and Unseen: A dark figure is appearing near the Christmas displays Popular Gospel Singer Dead at 30 After Collapsing on Stage Draymond Green Suspended Indefinitely by NBA I lost my son in ... Wed, 13 Dec 2023 10:01:00 -0600 en-us text/html https://www.msn.com/ What to know about compression therapy and how it can help medical conditions

Compression therapy, in which pressure is applied to certain areas of the body, has been proven to help with specific medical issues and is relatively easy to use.

“Compression for lower extremities helps prevent or decrease swelling seen in the lower legs or when the legs are in a dependent position, sitting or standing,” Danielle Bajakian, M.D., a vascular surgeon at Columbia University Irving Medical Center in New York, told Fox News Digital.

Here’s a deeper dive and what to know.

What is compression therapy?

Compression therapy can be used to help Strengthen blood flow and decrease perceived muscle soreness related to exercise and activity.

That’s according to Chicago-based Leo Arguelles, PT, DPT, a spokesperson with the American Physical Therapy Association. 

“It is most commonly used in the case of sleeves worn on the lower legs, but it can also be used for the upper extremities,” he said.

He said types may include:

  • Compression bandaging
  • Compression garments or sleeves
  • Taping
  • Total contact casting
  • Pneumatic compression devices (sleeves worn around legs that fill with air and squeeze)

Who can benefit from compression therapy?

Dr. Bajakian of Columbia University said patients who most commonly benefit from this are those with venous insufficiency or deep vein thrombosis.

Compression therapy can be used to help Strengthen blood flow and decrease perceived muscle soreness related to exercise and activity. Compression garments and sleeves can help both on the legs and arms. Getty Images/iStockphoto

Others who can benefit: pregnant women in their second and third trimester, when their blood volume increases; patients with lymphedema (a build-up of lymph fluid in the fatty tissues just under the skin); and patients with heart failure or other medical conditions that prevent venous return, resulting in leg edema.

Should people buy OTC compression clothing?

For most patients with mild symptoms, OTC compression clothing works well, Dr. Bajakian said. 

“The keys to effective compression garments are compliance and fit,” she added. 

For a compression garment to work, the fit needs to be snug. 

For socks, there are usually sizing guidelines for calf circumference and leg length from knee to ankle, she said. 

Walking and exercising the legs, especially the calf muscles, can help with venous insufficiency as well, said one medical expert. Getty Images/iStockphoto

“They should fit tightly around the ankle and looser as they get higher toward the knee,” Dr. Bajakian noted. 

“Regarding compliance, over the counter brands offer an array of styles and fabrics that work with different lifestyles,” she also noted. “I often see better compliance with those than a medical grade compression garment.”

She clarified that for patients with severe symptoms or diagnoses such as lymphedema, medical-grade compression garments are essential.

When else can compression therapy be helpful?

People who are on their feet for long periods of time may benefit from graduated compression stockings that can help with the swelling and discomfort that may come from blood pooling in the ankles. Getty Images/iStockphoto

Sunil Iyer, M.D., FACC, an interventional cardiologist and vascular medicine specialist with Novant Health Heart & Vascular Institute in Wilmington, North Carolina, told Fox News Digital that for people who are on their feet for long periods of time — or who are going for long car rides or airplane rides — graduated compression stockings can help with the swelling and discomfort that may come from the blood pooling in the ankles. 

“This can even help varicose veins not to form or not to be as engorged and painful,” Dr. Iyer said. 

Compression stockings are part of the treatment, he said. 

In addition, walking and exercising the legs, especially the calf muscles, can help with venous insufficiency as well, he said. 

“Diet is also important. Patients may note that the swelling is worse after they drink a lot of fluids or eat a lot of salt,” he said.

Do people need to speak to a doctor before they buy compression socks?

For patients with minimal medical problems who are looking to Strengthen vein health, there is no need to consult a physician prior to buying compression stockings, said Dr. Bajakian.  

“However, patients who are at risk of blood clots or who have unexplained leg swelling should seek out a doctor for a workup,” she said. 

Mon, 11 Dec 2023 08:18:00 -0600 en-US text/html https://nypost.com/2023/12/11/lifestyle/what-to-know-about-compression-therapy-and-how-it-can-help-medical-conditions/
What is compression therapy and how does it help certain medical conditions? No result found, try new keyword!Compression therapy — when pressure is applied to certain parts of the body — can help prevent or decrease swelling in the legs, which can be due to many issues. Here's more health insight. Sun, 10 Dec 2023 19:15:21 -0600 en-us text/html https://www.msn.com/ FUSION Vascular Graft from Maquet

The MAQUET line of FUSION grafts merges ePTFE with PET to offer vascular surgeons the best of both materials: the easy handling of ePTFE and the minimal suture hole bleeding seen in knit polyester grafts. The two-layer construction of FUSION grafts delivers benefits during and after peripheral bypass surgery:

  • Axial compliance for better handling compared with standard ePTFE grafts
  • High suture retention strength and durability for long-term performance
  • Kink resistant to enhance blood flow
  • Minimal suture hole bleeding for improved hemostasis
  • Crush resistant to help enhance flow dynamics

Hybrid Construction: ePTFE and PET Layers

The inner layer of the FUSION graft is comprised of extruded, expanded polytetrafluoroethylene (ePTFE). The outer layer is a knit polyester textile, polyethylene terephthalate (PET). These two layers are fused together with a proprietary polycarbonate-urethane adhesive.

Wed, 20 Dec 2023 10:00:00 -0600 en text/html https://www.news-medical.net/FUSION-Vascular-Graft-from-Maquet
Argon Medical Launches Kodiak™ Dual Port Coaxial Introducer Kit for Complex Vascular Procedures

PLANO, Texas, Nov. 30, 2023 /PRNewswire/ -- Argon Medical Devices, a leading provider of device solutions for Interventional Radiology, Vascular Surgery, Interventional Cardiology, and Oncology, announced the launch of the Kodiak™ Dual Port Coaxial Introducer Kit for precise and streamlined introduction of diagnostic and therapeutic devices into the vasculature.

Kodiak™ Dual Port Coaxial Introducer Kit

The Kodiak Dual Port Coaxial Introducer Kit is engineered for versatility, as it applies to various vascular procedures. Kodiak allows physicians to utilize a robust, large-bore sheath and a unique Y-shaped adapter to introduce multiple components simultaneously through a single access site. In doing so, Kodiak can simplify complex procedures where the rigor of the procedures demands a robust device to provide treatment efficiently.

"Complex IVC filter retrievals require stable and reliable access that can accommodate various retrieval methods. Kodiak provides reinforced support required for all advanced techniques of filter retrieval in one coaxial and valved system, providing the operator with the greatest flexibility in their procedural algorithm," said Dr. Julie Bulman, Interventional Radiologist, Beth Israel Deaconess Medical Center.

"We take great pride in unveiling yet another innovative device designed for interventionalists who rely on top-tier products to achieve successful procedural outcomes. The Kodiak was developed to fulfill the unmet need for a durable introducer system resilient enough to accommodate the anatomical diversity frequently encountered in vascular procedures. We are enthusiastic about adding Kodiak to our portfolio and anticipate that this new product will advance our mission to Strengthen the lives of caregivers and the patients they serve," said George Leondis, President & CEO, Argon Medical.

"The Kodiak Dual Port Coaxial Introducer Kit offers unmatched versatility and robustness, applicable to a variety of complex endovascular procedures that require simultaneous introduction of multiple components into the vasculature. This new device further expands the portfolio of differentiated solutions we provide to our customers for their complex vascular procedures, demonstrating our commitment to help them achieve their desired clinical outcomes more efficiently," said Tom Younker, Senior Vice President of Global Marketing, Argon Medical.

About Argon Medical

Since its founding in 1972, Argon Medical Devices earned a reputation for delivering innovative products, superior service, and exceptional value for Interventional Radiologists, Vascular Surgeons, and Interventional Cardiologists worldwide. Argon is proud to have over 1,100 employees, and manufacture products in the United States in Texas, Illinois, New York, and Wisconsin. Argon brands are well-known globally, highlighted by the Option™ ELITE IVC Filter, the Cleaner™ Rotational Thrombectomy System, the BioPince™ Ultra Full-core Biopsy Instrument, and SKATER™ Percutaneous Drainage Catheters. By utilizing a well-established sales and marketing infrastructure, Argon serves its global customers through a direct sales organization, and long-standing relationships with medical device distributors and strategic partners.

Argon Medical Devices, Inc. Logo.

Cision

View original content:https://www.prnewswire.com/apac/news-releases/argon-medical-launches-kodiak-dual-port-coaxial-introducer-kit-for-complex-vascular-procedures-302002151.html

SOURCE Argon Medical Devices, Inc.

Wed, 29 Nov 2023 19:22:00 -0600 en-US text/html https://finance.yahoo.com/news/argon-medical-launches-kodiak-dual-142200983.html
Study discovers novel biomarker for vascular aging and neurodegeneration

Decreased activity of a specific signaling pathway in brain vessels was linked to a decline in vascular function and subsequent neurodegeneration, according to a accurate Northwestern Medicine study published in the Journal of Clinical Investigation.

The study is the first to demonstrate that decreased activity of the Notch3 signaling pathway can be used as a biomarker for vascular aging and neurodegeneration, findings that could help inform the development of targeted therapies to prevent and treat age-related neurodegenerative diseases, according to Luisa Iruela-Arispe, Ph.D., the chair and Stephen Walter Ranson Professor of Cell and Developmental Biology, and senior author of the study.

"Our initial goal was to capture changes in the vasculature associated with aging. The study is foundational because it provides information related to physiological aging in the absence of any other confounding pathologies," said Arispe, who is also a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

An outcome of normal physiological aging is the progressive decline in the functioning of different organ systems, including the vascular system, which subsequently reduces blood flow to the brain, leading to and neurodegeneration.

Patients with vascular dementia experience , memory loss and changes in behavior. However, the underlying mechanisms of vascular dementia that cause this cascade of symptoms are not well understood.

"The intricate co-dependency between and the vasculature has been well acknowledged by clinicians and scientists, but how the aging vasculature affects the brain is less understood," Arispe said.

Using single-cell transcriptomics to study brain vessels from young and aging humans and mice, the scientists found in the aging mice a noticeable decline in the activation of the Notch3 signaling pathway. Notch3 signaling makes up one of four Notch receptors, which are essential for cell development and response to cellular stressors.

Credit: Northwestern University

Additional transcriptomics analysis and MRI scans of both mouse and human blood vessels revealed that reduction in Notch3 signaling altered the regulation of calcium and prevented blood vessels from properly contracting, which contributed to multiple vascular impairments, including dilation, microaneurysms, and decreased to the brain.

Furthermore, the investigators found these vascular impairments prevented proper glymphatic flow, or the clearing of waste and excess extracellular fluid from the central nervous system.

According to the authors, these pathological features are also observed in patients with CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy)—a rare, inherited type of vascular disease that causes dementia and is also associated with Notch3 mutations.

"The fact that we identified Notch3 as the top pathway altered by aging was powerful because of its known association with hereditary vascular dementia," Arispe said.

According to Arispe, her team's findings are essential for improving the understanding of what causes normal physiological aging without additional cofounding factors and confirms Notch3 as a biomarker of vascular aging.

Arispe said her team and collaborators are now particularly interested in determining whether intervening to increase Notch3 signaling in small muscle cells located in the wall of might rejuvenate contractility, and they also hope to develop more appropriate models of CADASIL to more accurately compare them to the progressive loss of Notch3 function in aging.

"My research group is extremely appreciative of the community of clinicians and scientists here are Feinberg and our extensive group of collaborators that contributed so much to this study and facilitated the extension of these findings to patients," Arispe said.

More information: Milagros C. Romay et al, Age-related loss of Notch3 underlies brain vascular contractility deficiencies, glymphatic dysfunction, and neurodegeneration in mice, Journal of Clinical Investigation (2023). DOI: 10.1172/JCI166134

Citation: Study discovers novel biomarker for vascular aging and neurodegeneration (2023, December 20) retrieved 5 January 2024 from https://medicalxpress.com/news/2023-12-biomarker-vascular-aging-neurodegeneration.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Tue, 19 Dec 2023 09:59:00 -0600 en text/html https://medicalxpress.com/news/2023-12-biomarker-vascular-aging-neurodegeneration.html
Cardiothoracic and Vascular Surgeons Files Notice of Data Breach Affecting an Unknown Number of Patient SSNs

On December 12, 2023, Cardiothoracic and Vascular Surgeons, P.A. (“CTVS”) filed a notice of data breach with the U.S. Department of Health and Human Services Office for Civil Rights after discovering that information on the company’s computer network was subject to unauthorized access. In this notice, CTVS explains that the incident resulted in an unauthorized party being able to access consumers’ sensitive information, which includes their names, Social Security Numbers, financial account information, driver’s license numbers, dates of birth, medical record numbers, and health information. Upon completing its investigation, CTVS began sending out data breach notification letters to all individuals whose information was affected by the accurate data security incident.

If you receive a data breach notification from Cardiothoracic and Vascular Surgeons, P.A., it is essential you understand what is at risk and what you can do about it. A data breach lawyer can help you learn more about how to protect yourself from becoming a victim of fraud or identity theft, as well as discuss your legal options following the Cardiothoracic and Vascular Surgeons data breach. For more information, please see our accurate piece on the topic here.

What Caused the Cardiothoracic and Vascular Surgeons Data Breach?

The Cardiothoracic and Vascular Surgeons data breach was only recently announced, and more information is expected in the near future. However, CTVS’s filing with the U.S. Department of Health and Human Services Office for Civil Rights provides some important information on what led up to the breach. According to this source, on October 13, 2023, CTVS detected unusual activity within its computer system. In response, CTVS secured its systems and then began working with outside cybersecurity certified to investigate the incident.

The CTVS investigation confirmed that an unauthorized party was able to access and potentially acquire confidential patient information stored on the company’s computer network. The period of unauthorized access was between October 12, 2023 and October 13, 2023.

After learning that sensitive consumer data was accessible to an unauthorized party, Cardiothoracic and Vascular Surgeons reviewed the compromised files to determine what information was leaked and which consumers were impacted. While the breached information varies depending on the individual, it may include your name, Social Security number, credit card information, account number and password, financial account information, driver’s license number, date of birth, medical record number, health insurance numbers and other health insurance information, patient account number, doctor or medical professional name, treatment information, procedure code, diagnosis code, Medicaid/Medicare number, dates of treatment, prescription information, diagnosis and symptoms information.

On December 12, 2023, Cardiothoracic and Vascular Surgeons sent out data breach letters to anyone who was affected by the accurate data security incident. These letters should provide victims with a list of what information belonging to them was compromised.

More Information About Cardiothoracic and Vascular Surgeons, P.A.

Cardiothoracic and Vascular Surgeons, P.A. is a healthcare provider that specializes in surgery of the heart, lungs, chest, esophagus, and major blood vessels of the body. CTVS operates three locations in central Texas, including in Austin, Kyle, and Georgetown. Cardiothoracic and Vascular Surgeons employs more than 87 people and generates approximately $12 million in annual revenue.

Wed, 27 Dec 2023 10:00:00 -0600 en text/html https://www.jdsupra.com/legalnews/cardiothoracic-and-vascular-surgeons-4515965/




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