A 65-year-old client with osteomyelitis is receiving long-term antibiotic therapy. The nurse is preparing to administer the next dose of intermittent intravenous (IV) ceftriaxone through the client's open-ended central venous catheter (CVC). The designated lumen is currently capped and has not been used for 12 hours. Place the following steps in the correct chronological order to safely administer the medication and maintain catheter patency.
- 1Scrub the needleless connector, attach a saline syringe, unclamp the catheter, and aspirate for a blood return.
- 2Using the attached syringe, flush the catheter with 10 mL of 0.9% sodium chloride using a pulsatile technique.
- 3Connect the antibiotic tubing and administer the intermittent intravenous ceftriaxone.
- 4Disconnect the empty antibiotic tubing, scrub the connector, and flush with 10 mL of 0.9% sodium chloride.
- 5Scrub the connector, instill the prescribed volume of heparin flush solution, and close the catheter clamp.
Cevap
The correct chronological sequence follows the SASH protocol: Aspirate for a blood return, flush with saline, administer the medication, flush with saline again, and finish with a heparin lock.
The SASH protocol dictates the safe administration of medications via an open-ended central venous catheter. First, the nurse must scrub the hub and aspirate to confirm placement and patency. Next, a normal saline flush clears the line and confirms there is no resistance. The medication is then administered. A second saline flush is mandatory after the infusion to clear the medication and prevent chemical precipitation with the final step, which is a heparin lock to maintain catheter patency until the next use.
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Anahtar Kavram
The SASH (Saline, Administer, Saline, Heparin) method is the evidence-based standard protocol for administering medications and maintaining patency in open-ended central venous catheters.
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