ATI Question

[fabiusgile]

A nurse is changing the IV administration set for a client who has a nontunneled percutaneous central catheter (triple lumen). Which of the following actions should the nurse take to prevent an air embolus?

A Instruct the pt to hold her breath and bear down.

B Place the client in the semi-fowler's postiion

C Flush the line with 10 ml of normal saline

D. Access the cath port with a noncoring needle.

Can you explain why you chose your answer and maybe dirrect me to some info on triple lumen catheters. I don't remember covering them at all in lecture.

[Daytonite, BSN, RN]

a nurse is changing the iv administration set for a client who has a nontunneled percutaneous central catheter (triple lumen). which of the following actions should the nurse take to prevent an air embolus?

a instruct the pt to hold her breath and bear down.

b place the client in the semi-fowler's postiion

c flush the line with 10 ml of normal saline

d. access the cath port with a noncoring needle.

negative pressure in the chest during respiration is what sucks atmospheric air into the open end of the triple lumen catheter when the nurse is changing the iv administration set. having the patient hold their breath and bear down during the iv tubing change is called the valsalva maneuver. it creates positive pressure in the chest and stops air from entering the open port of the triple lumen catheter and being sucked into it. answer "b" placing the patient in semi-fowler's position will have no effect in preventing an air embolus. in fact, if an air embolus is suspected of occurring the patient should be immediately turned to the left side and placed in reverse trendelenburg position with their head down so that the air bubble ends up trapped in the apex of the right ventricle of their heart. answer "c" flushing the line with 10 ml of normal saline is only going to flush any air bubble that got into the catheter right into the heart and then the pulmonary circulation where it will become trapped, if you're lucky; if not lucky, the embolus will break up and travel to other organs where the emboli will become trapped and result in infarcts of the tissues there. "d" accessing the cath port with a noncoring needle doesn't even apply to triple lumen catheters or this issue of air embolus; it is something that is done with implanted ports and only to access the port.

can you direct me to some info on triple lumen catheters.

see post #5 on this sticky thread

https://allnurses.com/nursing-student-assistance/any-good-iv-127657.html

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any good iv therapy or nursing procedure web sites

for all kinds of iv weblinks that will help you.