Exam 2 - Central Lines

A nurse is assisting a primary healthcare provider with insertion of a central venous access catheter. Which equipment will the nurse plan to have in the room to help prepare the skin? Select all that apply: Mask Gown Checklist Sterile gloves Chlorhexidine

All of the above

A peripherally inserted central venous catheter (PICC) has just been inserted into the arm of a seven-year-old child. A peripheral intravenous line is still in place, and an antibiotic is to be administered immediately. What is the nurses first action?

Connecting the IV anabiotic to the peripheral line Rationale: the peripheral line must be used until the placement of the central venous line is confirmed with radiography or fluoroscopy; this prevents the installation of fluid into the lungs or interstitial space if the catheter is misplaced. Essential and should not be used until placement is confirmed.

A client has surgery for the insertion of an implanted infusion port for chemotherapy. The client asks, "the doctor said after my chemotherapy is finished, the port will stay in, but it needs to be flushed routinely. How often does this have to be done?" What should the nurse tell the client about how often the port will most likely need to be flushed when not in use?

Every month Rationale: once a month flushes usually are adequate to keep an implant infusion port from clotting.

The nurse is caring for a client who has an implant in Port and is receiving intravenous fluids. To decrease the risk of infection, the nurse should change the non-coring needle how often?

Every seven days Rationale: best practice guidelines indicate that non-coring needles be changed at least every seven days to decrease risk of infection.

A client is receiving total parenteral nutrition (TPN) through a central venous access device. The nurse discovered that the TPN bag is empty and the next bag has not been received yet from the pharmacy. What is the most appropriate action for the nurse to take?

Hang a bag of 10% dextrose at the ordered TPN rate and place an urgent request for the next TPN bag. Rationale: clients receiving TPN require monitoring a blood glucose because the TPN solution contains a high concentration of dextrose. In this situation, the current TPN infused is completed, and the nurse should infuse 10% dextrose to compensate for the loss while the next TPN bag is being prepared. If this action is not taken, the client could experience a profound hypoglycemic reaction.

A client is receiving total parenteral nutrition through a central venous access device. What important nursing intervention should be included?

Placing the client in the supine position before changing the tubing Rationale: placing the client in the supine position before changing the tubing decreases pressure in the vena cava, which helps prevent an air embolus when the catheter is disconnected.

A client will be discharged with a peripherally inserted central venous catheter (PICC) for administration of peripheral parenteral nutrition (PPN). What would be appropriate for the nurse to include in the clients discharge teaching?

Scheduling administration of the PPN solution around meal times Rationale: professional assistance will ensure correct administration, which may limit complications such as intravascular overload and sepsis; eventually, the client may self administer the PPN with supervision.

A primary healthcare provider prescribes total paren Terrel nutrition for a client with cancer of the pancreas. Essential venous access devices inserted. What does the nurse identify as the most important reason for using this type of access?

The amount of blood in a major vein helps to dilute the solution. Rationale: unless diluted, the highly concentrated solution can cause vein irritation or occlusion.

The nurse is administering medication through an implanted Port. What nursing safety priority should the nurse follow in this scenario?

The nurse should withhold the drug until patency and adequate non-coring needle placement of the ports are established. Rationale: when administering medication through implanted ports, the nurse should withhold the drug until patency and adequate non-coring needle placement of the port are established. In case of a PICC, the nurse should use barrel syringe is to flush any central line.