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Zorluk: OrtaPharmacological and Parenteral Therapies

A client receiving care on an oncology unit has a newly inserted multi-lumen central venous catheter (CVC) for the administration of chemotherapy and total parenteral nutrition. The nurse is preparing to administer several prescribed intravenous medications. Which of the following actions indicate correct understanding of central line and parenteral therapy safety? Select all that apply.

  1. Use a syringe size of 10 mL10 \text{ mL} or larger when flushing the catheter lumens.Cevap
  2. B
    Delegate the routine assessment of the central venous catheter insertion site to the unlicensed assistive personnel.
  3. Aspirate the line to verify a brisk blood return prior to the administration of any intravenous vesicant medication.Cevap
  4. D
    Administer incompatible intravenous medications simultaneously if they are pushed rapidly through the same lumen.
  5. Scrub the needleless connector hub with an approved antiseptic for at least 15 seconds and allow it to dry before accessing.Cevap
  6. F
    Place the client in a high Fowler's position immediately if shortness of breath and an air embolism are suspected.

Cevap

The correct actions include using a 10 mL10 \text{ mL} or larger syringe for flushing, aspirating for blood return before giving vesicants, and scrubbing the hub for at least 15 seconds before access.
The correct actions ensure patient safety during central line use. A 10 mL10 \text{ mL} or larger syringe must be used because smaller syringes exert excessive pressure that can rupture the central venous catheter. Aspirating for blood return is a critical step prior to administering any vesicant to confirm the catheter tip is properly placed in the vein, thus preventing severe extravasation injury. Scrubbing the needleless hub with an antiseptic for at least 15 seconds creates mechanical friction that significantly reduces the risk of central line-associated bloodstream infections (CLABSI).

Adım Adım Çözüm

1
Evaluate the requirement for syringe size when flushing a central line.
Syringes smaller than 10 mL10 \text{ mL} generate too much pressure.
High pressure can cause catheter rupture or dislodgment.
2
Determine the appropriate scope of practice for assessing the insertion site.
Assessment requires clinical judgment.
Assessment cannot be delegated to unlicensed assistive personnel (UAP).
3
Review the protocol for administering vesicant medications.
Blood return must be verified.
Ensuring the catheter is correctly situated in the vein prevents severe tissue damage from extravasation.
4
Analyze the rules for medication compatibility.
Incompatible medications cannot be mixed.
Administering them in the same lumen, regardless of speed, can cause dangerous precipitates to form.
5
Identify infection control standards for accessing a central line.
The hub must be scrubbed thoroughly.
Friction and antiseptic application for at least 15 seconds prevent central line-associated bloodstream infections (CLABSI).
6
Establish the correct emergency positioning for a suspected air embolism.
The client should be placed in the left lateral Trendelenburg position.
High Fowler's position would exacerbate the issue; the left lateral Trendelenburg position helps trap air in the right atrium and prevents it from entering the pulmonary circulation.

Anahtar Kavram

Central Venous Catheter Safety and Parenteral Administration Protocols
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Konular

Pharmacological and Parenteral Therapies

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