A patient is admitted to the critical care unit with severe malnutrition as a result of hepatic failure. A triple-lumen central venous catheter is placed in the right subclavian vein, and TPN is started
For which of the following complications should the patient be evaluated immediately after insertion of the catheter? a. Pneumothorax c. Central venous thrombosis
b. Hypoglycemia d. Pulmonary aspiration
A
Central vein TPN carries an increased risk of sepsis as well as potential insertion-related complications such as pneumothorax and hemothorax. Repeated traumatic catheterizations are most likely to result in thrombosis. To prevent hypoglycemia, administer oral carbohydrates or an IV bolus of dextrose. Elevate the head of the bed 30 to 45 degrees to prevent pulmonary aspiration after the infusion has begun.
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