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Difficulty: EasyReduction of Risk Potential

A nurse is preparing to draw a blood sample for laboratory testing from a client's central venous catheter (CVC). To reduce the risk of infection and ensure accurate laboratory results, arrange the following nursing actions in the correct chronological order.

  1. 1Perform hand hygiene and put on clean gloves.
  2. 2Scrub the central line catheter hub with an appropriate antimicrobial swab.
  3. 3Attach a syringe, aspirate for a blood return, and flush the catheter with normal saline.
  4. 4Withdraw and discard the required initial waste volume of blood.
  5. 5Obtain the required blood sample using a new, sterile syringe.

Answer

The correct chronological sequence is: perform hand hygiene and don gloves, scrub the catheter hub, check patency by aspirating and flushing, discard the waste blood volume, and finally obtain the pure blood sample.
Following this exact procedural sequence prioritizes client safety by minimizing the risk of central line-associated bloodstream infections (CLABSI) and preventing the reporting of inaccurate laboratory values. Infection control (hand hygiene and scrubbing the hub) must always occur first. Next, verifying patency and flushing ensures the line is functional. Crucially, the nurse must then withdraw and discard the initial 'waste' blood to clear the line of any residual IV fluids or medications. Finally, a pristine, undiluted sample is drawn using a new syringe.

Step-by-Step Solution

1
Initiate baseline infection control measures.
Hand hygiene is performed and clean gloves are donned.
To establish a clean environment and protect the client from exogenous pathogens.
2
Disinfect the access port.
The central line hub is scrubbed vigorously with an antimicrobial swab.
To mechanically remove and eliminate surface bacteria, minimizing the direct risk of introducing a central line-associated bloodstream infection (CLABSI).
3
Verify line patency and clear the line.
The nurse aspirates for a blood return and flushes the line with normal saline.
To confirm the central line is functioning properly and is free of occlusions or incompatible fluids before drawing blood.
4
Clear the catheter dead space.
A specific volume of blood is withdrawn and safely discarded.
To remove any residual medications or saline in the catheter that could dilute the blood sample, ensuring the laboratory results accurately reflect the client's systemic condition.
5
Collect the diagnostic specimen.
A new syringe is attached to draw the necessary volume for the prescribed laboratory tests.
To obtain an uncontaminated, undiluted blood sample for laboratory analysis.

Key Concept

Reduction of Risk Potential: Central Venous Catheter Blood Draw Sequence
Estimated Time:45s
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Topics

Reduction of Risk Potential

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