# A client receives parenteral nutrition through a central venous catheter. Highlight the findings that require prompt catheter-infection follow-up.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522665&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client receives parenteral nutrition through a central venous catheter. Highlight the findings that require prompt catheter-infection follow-up.

| Domain | Finding |
| --- | --- |
| Systemic | New fever with shaking chills during the infusion |
| Site | Purulent drainage at the catheter insertion site |
| Site | New tenderness along the catheter tract |
| Dressing | Transparent dressing is wet and lifting at two edges |
| Dressing | Dressing is clean, dry, dated, and intact |
| Lumen | Dedicated lumen remains capped when not in use |
| Technique | Antiseptic solution was allowed to dry before access |
| Monitoring | Temperature remains at the documented baseline |

## Explanation

Fever with rigors, drainage, insertion-site tenderness, and a wet or loose dressing require prompt central-line assessment and protocol-based follow-up. A clean dry dressing and intact dedicated lumen are protective findings.

## In-depth explanation

Quick answer
Escalate systemic infection cues and loss of dressing or site integrity.

Why this is correct
Central access can deliver organisms directly into the bloodstream. Dressing integrity, aseptic hub access, skin antisepsis, and prompt response to infection cues are core protections.

Easy analogy or mental picture
Treat every infusion as a controlled clinical system: verify the product and access, recognize a changing cue, stop preventable exposure, stabilize the client, and confirm the response.

Memory hook
Product, access, compatibility, infusion cue, protective action, and reassessment.

NCLEX decision rule
Choose the action that prevents the most immediate infusion-related harm while preserving vascular access and the ordered diagnostic evidence.

Why the other choices are wrong
Options that restart a suspect product, bypass a safety device, force an occluded tube, or delay reassessment can convert a reversible warning into serious harm.References
1CDC Guidelines for Prevention of Intravascular Catheter-Related InfectionsChlorhexidine-alcohol skin preparation, drying, sterile barrier practice, dressing integrity, and infection assessment
2ASPEN Parenteral Nutrition Safety Consensus RecommendationsDedicated access, compatibility, admixture protection, infection prevention, laboratory surveillance, and safe administration

## Clinical scenario

Blood product, nutrition, and intravenous-fluid safety review
Verify the product, prescription, route, access device, filter or tubing, compatibility, baseline findings, emerging adverse cues, response plan, and measurable follow-up.

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