Central Venous Catheter

Question 1

Central Venous Catheter - Definition

Answer 1

An indwelling catheter inserted into a large, central vein

Question 2

Central Venous Catheter - Insertion Sites

Answer 2

• Internal jugular
• Subclavian
• Femoral vein

Question 3

Central Venous Catheter - Inserting Above Heart

Answer 3

Terminates in bottom 3rd od superior vena cava

Question 4

Central Venous Catheter - Inserting Below Heart

Answer 4

Terminates in top 3rd inferior vena cava

Question 5

Central Venous Catheter - Purpose

Answer 5

• IV infusions
• Measure fluid status
  > central venous pressure (CVP)
  > preload

Question 6

Preload

Answer 6

Pressure created by volume in right side of heart. When tricuspid valve opens, the CVP reflects filling pressures in the right ventricle

Question 7

Central Venous Catheter - Most Common Complications: Air Embolus

Answer 7

• Causes
  > broken catheter
  > open stopcock
  > catheter not flushed before insertion
• Signs & Symptoms
  > not subtle
  > acute resp distress
  > SOB
  > chest pain
  > dcrd O2 sat
  > cv collapse
• Priority Intervetion: 1st occlude external site with DRESSING 2nd 100% oxygen 3rd left lateral trend position 4th notify physician

Question 8

Central Venous Catheter - Most Common Complications: Thrombus Formation

Answer 8

• Causes: fibrin sheath around catheter; not flushing adequately (after meds)
• Signs & Symptoms: cath hard to flush/draw back, CVP dampened
• Priority Intervention: prevention, flush after meds, low dose TPA

Question 9

Central Venous Catheter - Most Common Complications: Infection

Answer 9

• Signs & Symptoms: fever, red site, warm, discharge
• Priority Intervention: prevention, sterile technique

Question 10

Central Venous Catheter - Removal

Answer 10

• Optimal position: flat on back in bed, trend
• Pull cath on exhale
  > pulling while inhaling can cause air embolism
• Most common complications
  > air embolism (remember intervention!)
  > bleeding: firm pressure on site