A clinical nurse is preparing to draw a blood specimen for a comprehensive metabolic panel (CMP) from an adult client's triple-lumen central venous access device (CVAD). The client currently has a continuous intravenous infusion of 0.9% sodium chloride with 20 mEq of potassium chloride infusing through the proximal lumen. To ensure accurate laboratory results and reduce the risk of infection, in what order should the nurse perform the following actions? Arrange the steps in the correct sequence.
- 1Pause the continuous intravenous infusion and wait at least one minute.
- 2Scrub the needleless connector of the designated lumen with an antiseptic swab.
- 3Attach a syringe and aspirate 5 mL of blood to discard.
- 4Attach a new syringe to withdraw the required volume of blood for the laboratory sample.
- 5Flush the catheter lumen with 10 to 20 mL of sterile 0.9% sodium chloride.
Cevap
The correct sequence is: Pause the continuous intravenous infusion -> Scrub the needleless connector -> Aspirate 5 mL of blood to discard -> Withdraw the required volume of blood -> Flush the catheter lumen.
The correct sequence prioritizes analytical accuracy and infection control. First, pausing the infusion prevents drawing a diluted or contaminated sample. Scrubbing the hub is the primary defense against CLABSI. Discarding the initial 5 mL ensures the sample is pure whole blood, not the dwelling medication. Drawing the sample follows, and the procedure concludes with a thorough saline flush to clear the line and maintain patency.
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Anahtar Kavram
Central Venous Access Device (CVAD) Blood Sampling Sequence