The nurse is caring for a client with a central venous catheter used for intermittent medication administration. When flushing the catheter prior to administering the next dose of medication, which initial action by the nurse is the most appropriate?
1. Aspirating the catheter for blood
2. Obtaining a 3 mL syringe and filling it with normal saline for flushing the line
3. Flushing the catheter, using as much force as required in order to clear the line
4. Positioning the client in reverse Trendelenburg position
1
Rationale 1: The catheter should be aspirated for blood prior to flushing the tubing.
Rationale 2: The tubing would be flushed with a 10 mL syringe or larger because small syringes exert too much pressure, which can damage the catheter.
Rationale 3: Excessive pressure should not be used when flushing the catheter, because it can dislodge a clot or cause the catheter to rupture.
Rationale 4: There would be no need to place the client in reverse Trendelenburg position, although a left Trendelenburg position may be used if an air embolism is suspected.
Global Rationale: The catheter should be aspirated for blood prior to flushing the tubing. The tubing would be flushed with a 10 mL syringe or larger because small syringes exert too much pressure, which can damage the catheter. Excessive pressure should not be used when flushing the catheter, because it can dislodge a clot or cause the catheter to rupture. There would be no need to place the client in reverse Trendelenburg position, although a left Trendelenburg position may be used if an air embolism is suspected.
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