Techniques of Peripheral and Central Vascular Access
Techniques of Peripheral and Central Vascular Access ( 5 Questions)
A nurse is preparing to administer intravenous fluids to a client who has a central venous access in the internal jugular vein. Which of the following actions should the nurse take? (Select all that apply.)
Incorrect. Checking the patency of the catheter by flushing it with normal saline is not necessary for a central venous access device (CVAD) that is already in place and functioning. Flushing is done before and after each medication administration or every 8 hours when medications are not being given.
Correct. Using aseptic technique when accessing the catheter is essential to prevent catheter-related bloodstream infections (CRBSIs), which are a serious complication of CVADs. The nurse should wear gloves, mask, and gown and use sterile equipment when changing the dressing or tubing.
Incorrect. Applying pressure dressing over the insertion site is not recommended for a CVAD in the internal jugular vein. Pressure dressings can increase the risk of thrombosis and occlusion of the catheter. A transparent semipermeable dressing is preferred to allow for visualization of the site and prevent moisture accumulation.
Correct. Monitoring the client for signs of infection and air embolism is a vital action for the nurse to take when caring for a client with a CVAD. Signs of infection include fever, chills, redness, swelling, drainage, or tenderness at the insertion site. Signs of air embolism include dyspnea, chest pain, hypotension, tachycardia, or altered mental status. The nurse should promptly report any abnormal findings to the provider.
Correct. Changing the dressing and tubing according to facility protocol is another important action for the nurse to take to maintain the patency and integrity of the CVAD and prevent complications. The dressing should be changed every 5 to 7 days or more frequently if it becomes loose, wet, or soiled. The tubing should be changed every 72 to 96 hours or per manufacturer's recommendations.
Choice A reason:
Incorrect. Checking the patency of the catheter by flushing it with normal saline is not necessary for a central venous access device (CVAD) that is already in place and functioning. Flushing is done before and after each medication administration or every 8 hours when medications are not being given.
Choice B reason:
Correct. Using aseptic technique when accessing the catheter is essential to prevent catheter-related bloodstream infections (CRBSIs), which are a serious complication of CVADs. The nurse should wear gloves, mask, and gown and use sterile equipment when changing the dressing or tubing.
Choice C reason:
Incorrect. Applying pressure dressing over the insertion site is not recommended for a CVAD in the internal jugular vein. Pressure dressings can increase the risk of thrombosis and occlusion of the catheter. A transparent semipermeable dressing is preferred to allow for visualization of the site and prevent moisture accumulation.
Choice D reason:
Correct. Monitoring the client for signs of infection and air embolism is a vital action for the nurse to take when caring for a client with a CVAD. Signs of infection include fever, chills, redness, swelling, drainage, or tenderness at the insertion site. Signs of air embolism include dyspnea, chest pain, hypotension, tachycardia, or altered mental status. The nurse should promptly report any abnormal findings to the provider.
Choice E reason:
Correct. Changing the dressing and tubing according to facility protocol is another important action for the nurse to take to maintain the patency and integrity of the CVAD and prevent complications. The dressing should be changed every 5 to 7 days or more frequently if it becomes loose, wet, or soiled. The tubing should be changed every 72 to 96 hours or per manufacturer's recommendations.