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    Pn comprehensive predictor 2023 proctored exam

    A nurse is assisting with preparing a client who is to have a central venous catheter inserted for the administration of total parenteral nutrition (TPN). Which of the following actions should the nurse take?

    Explanation & Rationale

    A) Place the client in Sims' position for catheter insertion: Sims' position (side-lying position) is not typically used for central venous catheter insertion. The client is usually placed in a supine or Trendelenburg position to help facilitate insertion and decrease the risk of air embolism during the procedure. B) Prepare the client for a chest x-ray to verify catheter placement: After the insertion of a central venous catheter, a chest x-ray is routinely performed to verify the correct placement of the catheter in the superior vena cava or right atrium. This is essential to ensure the catheter is properly positioned and to check for complications like pneumothorax or inadvertent placement in the lung. C) Use clean technique when changing the catheter dressing: When changing the dressing for a central venous catheter, sterile technique is required, not clean technique. Sterile technique minimizes the risk of infection, which is a major concern when caring for central venous access devices. D) Verify the amount of TPN solution the client is receiving every 4 hr: While it is important to monitor the amount of TPN being infused and assess for complications, verifying the exact amount every 4 hours is not a standard procedure. Typically, TPN is managed and adjusted by the healthcare provider based on lab results, weight, and clinical status, but constant monitoring of the solution is not required.

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