A clinical nurse is preparing to obtain a blood specimen from an adult client's central venous access device (CVAD). To reduce the risk of central line-associated bloodstream infection (CLABSI), inaccurate laboratory results, and catheter occlusion, place the following actions in the correct chronological order.
- 1Suspend any continuous intravenous infusions running through the central venous access device.
- 2Scrub the needleless connector hub with an appropriate antiseptic swab and allow it to dry completely.
- 3Attach an empty syringe, flush the catheter with 0.9% sodium chloride, and withdraw the designated discard volume.
- 4Connect a new sterile syringe or vacutainer to collect the required blood specimen for laboratory analysis.
- 5Flush the catheter lumen with 0.9% sodium chloride using a pulsatile technique.
Answer
The correct sequence for obtaining a blood specimen from a central line is: suspend continuous infusions, scrub the connector hub, flush and withdraw the discard volume, collect the blood specimen, and perform a final flush of the catheter.
The correct sequence prioritizes patient safety and sample integrity. First, continuous infusions must be suspended to prevent altering the laboratory results. Next, the needleless connector must be scrubbed and allowed to dry to prevent introducing pathogens (central line-associated bloodstream infection). After disinfection, the nurse flushes the line to assess patency and withdraws a discard volume to clear the catheter of any residual fluid or medication. A new, sterile device is then attached to collect the uncontaminated diagnostic specimen. Finally, the catheter must be flushed using a pulsatile technique to clear all red blood cells and prevent catheter occlusion.
Step-by-Step Solution
Key Concept
The correct sequence for drawing blood from a central venous access device prioritizes infection control, sample accuracy, and the prevention of catheter occlusion.