The nurse is caring for a patient following insertion of a left subclavian central venous catheter (CVC). Which action by the nurse best reduces the risk of catheter-related bloodstream infection (CRBSI)?
Review daily the necessity of the central venous catheter.
Maintain a pressure of 300 mm Hg on the flush bag.
Cleanse the insertion site daily with isopropyl alcohol.
Change the pressurized tubing system and flush bag daily.
The Correct Answer is A
A. Review daily the necessity of the central venous catheter: One of the most effective strategies to reduce the risk of catheter-related bloodstream infections is to remove the central line as soon as it is no longer needed. Daily evaluation of necessity prevents prolonged catheter use, which significantly increases infection risk. Removing the source of potential infection is the ultimate preventative action.
B. Maintain a pressure of 300 mm Hg on the flush bag: While maintaining appropriate flush pressure is important for catheter patency and preventing blood clots, it does not play a direct role in preventing bloodstream infections. This action is more related to ensuring adequate line function rather than infection control.
C. Cleanse the insertion site daily with isopropyl alcohol: Current guidelines recommend using chlorhexidine-based solutions rather than isopropyl alcohol for skin antisepsis due to better antimicrobial efficacy. Daily site care is important, but the choice of antiseptic is critical in reducing infection risk.
D. Change the pressurized tubing system and flush bag daily: Tubing and flush systems should be changed typically every 72–96 hours unless contamination is suspected. Changing them daily is not recommended and does not provide added protection against infection it may even increase risk with unnecessary manipulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "The diaphragmatic nerve overdrives the rapid rhythm:" The phrenic (diaphragmatic) nerve controls the diaphragm for breathing and plays no role in cardiac rhythm regulation. It is unrelated to the autonomic control of heart rate or supraventricular tachycardia (SVT) management.
B. "Vagal stimulation decreases peripheral vascular resistance:" Vagal stimulation primarily affects the heart by decreasing the rate and conduction through the AV node. Its effect on vascular resistance is minimal, making this explanation inaccurate in the context of SVT treatment.
C. "The vagus nerve increases the heart rate, overdriving the rhythm:" The vagus nerve has a parasympathetic effect, slowing down the heart rate, not increasing it. Overdrive pacing is a different concept and not related to vagal maneuvers like carotid massage.
D. "The vagus nerve slows the heart rate": The carotid sinuses in the neck contain baroreceptors that are sensitive to pressure. Massaging these sinuses stimulates the vagus nerve to release acetylcholine, which in turn slows conduction through the AV node and may terminate episodes of SVT. This response demonstrates an accurate understanding of the purpose of the procedure.
Correct Answer is ["2.5"]
Explanation
Convert the available dose from grams (Gm) to milligrams (mg):
0.15 Gm × 1000 mg/Gm = 150 mg
Desired dose = 75 mg
Available dose = 150 mg
Volume = 5 mL
Formula:
Volume to administer = Desired dose / Available dose × Volume
= 75 mg / 150 mg × 5 mL
= 0.5 × 5 mL
Volume to administer = 2.5 mL
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