# A client requires continued use of a central venous catheter. Complete the evidence-based maintenance and infection-prevention plan.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=563778&lang=en  
> language: en  
> subject: Central Venous Access Devices  
> category: PPT

## Question

A client requires continued use of a central venous catheter. Complete the evidence-based maintenance and infection-prevention plan.

Before manipulating the line, the nurse should ::선택::put on sterile gloves without cleaning the handsflush every lumen to test whether it is openpalpate beneath the dressing with bare fingersperform hand hygiene and gather supplies for aseptic care. The damp dressing requires ::선택::an additional layer of tape over the moistureobservation until the scheduled weekly changeprompt replacement using aseptic technique and recommended skin antisepsisroutine guidewire exchange of the catheter. Each connector access requires ::선택::access as soon as the cap looks visibly cleanfriction disinfection with the approved antiseptic and adequate drying before connectionrinsing the connector with tap waterleaving the connector open between infusions, and the team should ::선택::review catheter and lumen necessity daily and remove access that is no longer essentialretain every lumen until discharge regardless of usereplace the catheter on a fixed schedule to prevent all infectionswait for a positive blood culture before correcting technique.

## 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.

## In-depth explanation

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.

Sources
1CDC Intravascular Catheter Infection Prevention Strategies
2CDC Summary of Intravascular Catheter Recommendations
3NCSBN 2026 NCLEX-RN Test Plan

## Clinical scenario

Oncology unit
A 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.

## Key concepts

- **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.

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