A graduate nurse is caring for a client with a triple-lumen peripherally inserted central catheter in the right arm. Which actions by the graduate nurse indicate that more education is needed? Select all that apply. A)Flushing the line before and after each medication administration B)Pausing the parenteral nutrition prior to drawing blood from a different port C)Reinforcing a torn peripherally inserted central catheter line dressing with tape D)Scrubbing the port with alcohol for 5 seconds before use E)Taking the client's blood pressure in the left arm

Question

Quizplus · Accepted Answer

A peripherally inserted central catheter (PICC) is a venous access device that is inserted via the cephalic or basilic vein and terminates in the superior vena cava. It is indicated for administration of noxious medications (eg, parenteral nutrition, chemotherapy), for long-term IV therapy, or in clients with poor venous access. Proper care and aseptic technique are important to maintain lumen patency and eliminate the risk of life-threatening central line-associated bloodstream infection (CLABSI). The nurse should inspect the insertion site for signs of infection (redness, drainage) and dressing integrity. Routine care includes sterile dressing changes every 48 hours with a gauze dressing or 7 days with a transparent semipermeable dressing (biopatch) as well as immediately if dressing is loose/torn, soiled, or damp. The line should be flushed before and after medication administration and per facility protocol (Option A). Blood pressure and venipuncture should not be performed on the affected arm as compression of the vein can alter its integrity (Option E). All infusing medications (except vasopressors) must be paused before drawing blood from the PICC to prevent false interpretation of the client's serum levels (Option B). (Option C) Dressings that no longer occlude the insertion site must be changed immediately. Loose corners may be temporarily reinforced with tape. (Option D) The nurse should "scrub the hub" with alcohol or chlorhexidine/alcohol for 10-15 seconds. This should be done before flushing, drawing blood, or administering medication. Educational objective: Peripherally inserted central catheter lines provide central venous access for clients who require long-term medication administration or infusion of noxious substances. Maintaining the line integrity with aseptic technique and routine care (sterile dressing changes, flushing the line, blood pressures/venipunctures on unaffected arm) is important for continued use and prevention of central line-associated bloodstream infections.

A Graduate Nurse Is Caring for a Client with a Triple-Lumen