The nurse is assisting with the insertion of a subclavian central venous catheter. Which actions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. Place the patient in a prone position.
2. Ask the patient to turn the head away from the insertion site.
3. Alert the patient that the face may be covered temporarily with sterile drapes.
4. Place the bed in Trendelenburg position.
5. Ask the patient to cough when feeling the insertion catheter touch the skin.
2,3,4
Rationale 1: Prone positioning will not allow access to the subclavian vein.
Rationale 2: Having the patient turn the head away from the insertion site helps make it easier to visualize the site and also decreases the potential for contamination.
Rationale 3: To create a sterile field, the patient's upper torso, including the face, is covered with sterile drapes.
Rationale 4: The Trendelenburg position facilitates dilation of the central veins and reduces the risk of an air embolus.
Rationale 5: The patient should be asked to lie very still during this procedure. Coughing is not indicated.
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