An adult client in the intensive care unit (ICU) with a central venous catheter has developed signs and symptoms that are suggestive of a central line-associated bloodstream infection (CLABSI). What is most likely the cause of the infection?

The client was treated for vancomycin-resistant enterococcus (VRE) during a previous admission.

The client had blood cultures drawn from the central line.

The client's central line dressing was changed using clean technique.

The client has received antibiotics and intravenous fluids through the same line.

Answer and Explanation

The Correct Answer is C

A. The treatment for vancomycin-resistant enterococcus (VRE) in a previous admission is not directly related to the development of CLABSI in the current situation. The infection is more likely caused by improper handling or maintenance of the central line.
B. Drawing blood cultures from the central line, while not ideal, is not the most likely cause of CLABSI. Proper technique can mitigate the risk of introducing infection during this procedure.
C. Changing the central line dressing using clean technique instead of sterile technique increases the risk of introducing pathogens to the central line site, leading to a central line-associated bloodstream infection (CLABSI).
D. Receiving antibiotics and intravenous fluids through the same line does not typically cause CLABSI if the line is properly maintained and sterile techniques are observed during administration.

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Correct Answer is A

Explanation

A. Performing hand hygiene before, during, and after direct contact with the client is the most effective strategy for preventing the transmission of infections. Hand hygiene interrupts the transmission of pathogens and is a cornerstone of infection control practices.
B. Changing the client's bed linens each day is a standard practice for maintaining cleanliness but does not specifically prevent infection transmission. The primary goal of infection control is to reduce pathogen transmission rather than just maintaining general cleanliness.
C. Controlling the client's blood glucose level is important for overall health and wound healing but does not directly prevent infection transmission. It is not an infection control strategy.
D. Placing the client in a room with positive-pressure airflow is used to protect immunocompromised patients from infections by preventing outside air from entering the room. However, it is not appropriate for preventing the transmission of an infection from a client to others.

A. Check the intravenous (IV) site for bleeding every 8 hours. B. Administer stool softeners. C. Check the client for proteinuria. D. Obtain body temperature readings every 4 hours.

Correct Answer is B

Explanation

A. Checking the IV site for bleeding is important but should be done more frequently in a client with thrombocytopenia (low platelet count), as bleeding can occur unexpectedly.
B. Administering stool softeners is a key intervention for clients with thrombocytopenia, as it helps to prevent straining during bowel movements, which could cause rectal bleeding due to fragile blood vessels.
C. Checking for proteinuria is not directly related to thrombocytopenia or the risk of bleeding. It is more commonly associated with kidney function monitoring.
D. Obtaining body temperature readings is important for infection monitoring, but it does not directly address the risk associated with a low platelet count, which primarily concerns bleeding.

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An adult client in the intensive care unit (ICU) with a central venous catheter has developed signs and symptoms that are suggestive of a central line-associated bloodstream infection (CLABSI). What is most likely the cause of the infection?

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