# A central venous access device remains occluded 30 minutes after the prescribed Cathflo Activase dose was instilled. Which action is appropriate?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=513955&lang=en  
> language: en  
> subject: Medication Administration  
> category: PPT

## Question

A central venous access device remains occluded 30 minutes after the prescribed Cathflo Activase dose was instilled. Which action is appropriate?

## Option

1. Forcefully flush the lumen with 20 mL saline.
2. Administer a third 2 mg dose immediately.
3. Remove the catheter without further assessment.
4. Allow the dose to dwell and reassess catheter function at 120 minutes as prescribed. **✔ Correct answer**

**Correct answer: 4**

## Explanation

If function is not restored at 30 minutes, the label directs reassessment at 120 minutes before a second dose is considered.

## In-depth explanation

Quick answer
Continue the prescribed dwell and reassess at 120 minutes.

Why this is correct
Cathflo labeling assesses catheter function at 30 minutes and, when still occluded, again at 120 minutes. Only after the first dose fails at 120 minutes may an equal second dose be considered.

Easy analogy or mental picture
Give the key time to work before trying the next authorized step.

Memory hook
Cathflo checks at 30, then 120.

NCLEX decision rule
Follow the labeled intracatheter dwell and aspiration sequence; do not force a resistant line.

Why the other choices are wrong
Forceful flushing risks harm, a third dose exceeds the labeled sequence, and immediate removal skips the reassessment pathway.References
1DailyMed: Cathflo ActivaseOccluded central-line dwell, aspiration, and reassessment sequence

## Clinical scenario

Occlusion protocol
Verify catheter type, instilled dose, dwell time, ability to aspirate, and the maximum permitted dose sequence.

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