Question

Active Learning Template: Therapeutic Procedure

ATI Ch. 25

Pneumothorax and Hemothorax: Complications of a Central Venous Catheter

(Fill in the boxes)

description of procedure

Indications

Nursing Interventions

outcomes/evaluation

client education

potiential complications

nursing interventions due to the “potiential complications

Answer 1

Procedure

*Apply local anesthetic agent

*Identify location of vein using ultrasound

*Insert a hollow needle through the puncture site until blood comes through it

*A guidewire is inserted through needle and remove the needle

*finally central line is passed through guidewire and then remove the guidewire.

*Aspirate the central line to check the position and then flush with heparin or saline

*X ray may be taken to confirm the position.

Indications

Administering long term parentetal nutrition.

Chemotherapy

Long term administration of intravenous medication.

Dialysis

For taking blood samples for evaluation.

For monitoring central venous pressure.

Client education

-Educate regarding CVC care that is wash hands before touching the catheter, never use sharp instruments or scissors near the catheter, arrange all the articles.

Educate regarding catheter dressing that is to follow aseptic technique.

Instruct the patient not to force if there is any resistance felt in flusing the catheter.

Seek medical help immediately if catheter is pulled out, if you get a fever, tenderness, swelling, redness, shortness of breath etc.

Complications

Arterial puncture

Pneumothorax

Cardiac dysrhythmias

Air embolism

Infection

Nursing intervention

-Closely monitor catheter site.

-Monitor vital signs.

-Strict aseptic handling must be ensured.

-Dressing should be applied at site.

-Provide patient with a leg elevated position to prevent air embolism.

-During removal airtight dressing should be applied.