Skills Module 3.0: Central Venous Access Devices Posttest

A nurse in the emergency department is caring for a client who was in a motor-vehicle crash. The provider determines that the client needs immediate central venous access for fluid and blood replacement. Which of the following central venous access devices should the nurse anticipate being inserted?

A nontunneled percutaneous central catheter This type of central catheter is ideal for emergency situations where short-term (less than 6 weeks) central venous access is required for multiple therapies. This is the appropriate choice for this client.

A nurse is caring for a client who requires long-term central venous access and is an avid swimmer. Which of the following central venous access devices is the best choice for this client?

An implanted port Because the entire device lies beneath the skin, the client can be immersed in water when the device is not in use without any increased risk for infection. This is the best choice for clients who wish to continue aquatic activities.

A nurse is caring for a client who has a central venous catheter. When flushing the catheter, the nurse should use a 10-mL syringe to prevent which of the following complications associated with central vascular access devices?

Catheter rupture When injecting fluid through a catheter, a smaller syringe generates more pressure than a larger syringe does. Therefore, to reduce the risk of catheter rupture, syringes that are 10-mL or larger are recommended for flushing or injecting fluid into a central venous catheter.

A nurse is caring for a client who has an implanted port that needs to be accessed for an infusion. Which of the following actions should the nurse take?

Cover the device and the needle with a sterile transparent dressing. Once the implanted port has been accessed, the needle must be supported and anchored. The needle should be covered with a transparent dressing to secure the needle.

A nurse is caring for a client who has a central venous catheter and suddenly develops dyspnea, tachycardia, and dizziness. The nurse suspects an air embolism and clamps the catheter immediately. The nurse should reposition the client into which of the following positions?

On their left side in Trendelenburg position This position helps trap the air in the apex of the right atrium rather than allowing it to enter the right ventricle and, from there, move to the pulmonary arterial system.

A nurse is preparing to obtain a blood sample from a client who has a triple-lumen central catheter in place. Which of the following actions should the nurse take?

Turn off the distal infusions for 1 to 5 min before obtaining the blood sample. To help ensure that the laboratory results will not be altered by the solutions infusing through the central access device, it is recommended that the nurse stop the distal infusions and clamp the tubing for 1 to 5 min before obtaining the blood sample. How long to stop the infusion varies with the type of infusion.

A nurse is caring for a client who has a central venous access device in place. Which of the following routine interventions should the nurse use to prevent lumen occlusion?

Use a pulsatile action while flushing. Using a pulsatile action technique while flushing assists with the prevention of occlusion by removing possible solid deposits within the lumen.