A nurse is obtaining a blood specimen from a client who has a peripherally inserted central catheter. Which of the following actions should the nurse take?
Explanation & Rationale
A. Use a 3 mL syringe to flush the catheter: Small syringes (3 mL) create high pressure that can damage the lumen of a peripherally inserted central catheter (PICC). Larger syringes, typically 10 mL or greater, are recommended to safely flush and maintain catheter integrity. B. Cleanse the port with povidone-iodine prior to obtaining the specimen: Current guidelines recommend using an alcohol-based antiseptic (e.g., 70% isopropyl alcohol) rather than povidone-iodine for cleaning catheter hubs due to faster action and reduced contamination risk. C. Flush with 20 mL of 0.9% sodium chloride after obtaining the blood sample: While flushing is required, the volume depends on the protocol and whether blood was drawn for lab testing. Immediate flushing with 10 mL is often sufficient; 20 mL may be excessive unless the protocol specifies. D. Instruct the client to perform the Valsalva maneuver during the blood draw: Performing the Valsalva maneuver increases intrathoracic pressure and reduces the risk of air embolism when accessing a central line. This is a recommended safety measure during blood draws from PICC lines.