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Answer 14

Caregiver flushes the central venous catheter and they feel an unusual amount resistance to flushing. The catheter has the following appearance (see photo below). They call HPN on-call for advice. What is the first thing you should advise family to do? A. Offer reassurance if central line is not...

Question 15

Family notices there is something unusual about the appearance of their child’s central line (see photo below). The line is functioning fine. There is no leaking. The patient is asymptomatic. What is the problem? A. Outer lumen fracture B. Inner lumen fracture C. Central line thrombus D. Central...

Question 18

Patient complains of pain and burning during central line dressing changes with chlorhexadine. Central line exit site has the following appearance (see below). What is the proposed treatment plan? A. Use betadine cleanse for central line dressing changes for chemical burn. B. Prescribe IV...

Question 19

Patient had redness near central line exit site. The central line was inserted 1 year ago. The patient has no fevers or chills. What is the next step? A. Remove suture. B. Remove central line. C. Prescribe broad spectrum antibiotics. D. Prescribe steroids. E. Reassurance Click here for answer Go to...

Microvillus inclusion disease

This is a rare, autosomal recessive cause of congenital diarrheal. Types: Early onset (95%): since birth Late onset (5%): 1-3 months Pathophysiology: Mutations MYO5B STXBP2 STX3 Disorder of apical vesicle traficking Dhekne HS, Pylypenko O, Overeem AW, Ferreira RJ, van der Velde KJ, Rings EHHM...

Radiographic Findings with Central Venous Catheters

The optimal location of a central venous catheter tip is the cavoatrial junction. Acceptable locations include: Superior vena cava (including brachiocephalic - SVC junction) Right atrium Inferior vena cava Central venous catheter tip at cavoatrial junction Central venous catheter tip at...

Pre-discharge briefing meeting

Purpose: To confirm patient and family readiness for home parenteral nutrition https://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/st…

Question 1

Parent of a 1 year-old female on home parenteral nutrition secondary to short bowel syndrome (necrotizing enterocolitis) calls with a 2-day history of fever 101 degrees Fahrenheit (38.3 degrees Celsius). There are no other clinical complaints besides from teething. What is the next step? A...

Question 2

6 month-old male on home parenteral nutrition presents to emergency department with sudden onset altered mental status. On exam, patient is non-responsive, temperature 35 degrees Celsius, HR 180, blood pressure undetectable, skin is modeled. The central line site is clear. Blood cultures have been...