A client requires continued use of a central venous catheter. Complete the evidence-based maintenance and infection-prevention plan.
Drop-down Cloze
Choose your responses, then check the answer.
Explanation
Central venous catheter safety depends on competent aseptic maintenance and daily review of necessity. The nurse should perform hand hygiene, replace a damp or compromised dressing using appropriate aseptic technique and skin antisepsis, disinfect the connector before each access, and keep the system closed. The team should review whether the catheter and each lumen remain essential and remove unnecessary access promptly. Routine guidewire replacement or scheduled catheter exchange does not substitute for proper maintenance and can add mechanical risk.
Correct Answer Correct the compromised dressing and access technique now, then reassess catheter and lumen necessity every day.
Why It Fits Moisture and unverified connector disinfection create an avoidable route for contamination even before fever develops.
Clinical Picture Hand hygiene, aseptic access, chlorhexidine-based site care, trained personnel, and prompt removal of unnecessary catheters reduce catheter-related infection risk.
Memory Link Clean hands, clean hub, dry intact dressing, and no line without a need.
NCLEX Rule Replace compromised dressings aseptically, disinfect every access point, minimize manipulation and lumens, and remove the device when no longer essential.
Why the Alternatives Fail Waiting for fever, covering a damp dressing, or routinely exchanging the catheter over a guidewire does not address the current contamination risk.
2CDC Summary of Intravascular Catheter Recommendations
3NCSBN 2026 NCLEX-RN Test Plan
Oncology unitA client has a nontunneled central venous catheter for several incompatible intravenous therapies. During rounds, the transparent dressing is damp at one edge, one connector was accessed without observed disinfection, and the team is uncertain whether every lumen is still required. The client is afebrile and hemodynamically stable.
Central venous catheter — An intravascular device whose tip terminates in a large central vein for infusion, monitoring, or blood access.
Aseptic technique — Practices that prevent contamination by microorganisms during catheter access, dressing care, and other procedures.
CLABSI — A laboratory-confirmed bloodstream infection associated with the presence of a central line and not attributed to another site.