Prioritizing Patient Care with a Central Venous Catheter

Which action is the nurse's priority when caring for a client with a central venous catheter (CVC) who reports feeling nauseated and chilled, with the CVC insertion site red and inflamed?

• A. Administer ondansetron 4 mg IV push PRN for nausea or vomiting
• B. Document the occurrence and notify the hospital's epidemiology team
• C. Initiate the first dose of IV piperacillin/tazobactam via a new peripheral IV
• D. Obtain blood cultures and discontinue the central venous catheter

Answer: (A)

Focusing on the situation where a client with a central venous catheter exhibits nausea, chills, and a reddened, inflamed insertion site, addressing the problem promptly is crucial. The symptoms suggest a potential infection or complication related to the CVC, making it the nurse’s responsibility to assess and prioritize interventions accordingly. In this context, administering ondansetron is appropriate as it effectively manages nausea, providing immediate comfort to the patient. Alleviating nausea can help the patient feel more stable, allowing the nurse to perform necessary assessments and interventions without further distress. This action addresses a symptom directly impacting the patient's comfort and willingness to engage in further medical evaluations or treatments. While there may be other necessary actions, such as documenting the issue or treating a suspected infection, the immediate need to secure symptom relief takes precedence. By ensuring the patient is as comfortable as possible, the nurse can proceed to implement further evidence-based interventions effectively.

When you're caring for a patient with a central venous catheter (CVC), things can get a bit tricky—especially if your patient starts feeling nauseated and chilled, and their CVC insertion site looks a little red and inflamed. What do you do first? It’s a situation that calls for quick thinking and a solid grasp of nursing priorities. The right action could make all the difference for your patient, so let’s break it down!

First off, consider the patient’s symptoms. Nausea and chills combined with redness and inflammation at the CVC site suggest a possible infection or some other complication. In this case, prioritizing client comfort while addressing these symptoms is paramount. So, what’s the best first step? If you remember that your primary goal is to ensure patient stability, you land on the right answer: administering ondansetron 4 mg IV push as needed for nausea or vomiting.

Why is this so important? By alleviating nausea, you not only make your patient feel better but also offer them a sense of comfort that can significantly impact their overall willingness to continue with the necessary evaluations or treatments. Let’s face it—when patients are nauseated, they may feel overwhelmed or even resist further care. Kind of makes sense, right? That’s why you want to tackle that nausea first—let’s get them feeling at least a little more stable.

Now, while administering ondansetron is a priority, don’t forget that additional steps like documenting the occurrence and possibly consulting the hospital's epidemiology team are critical too. Just know that the immediate relief of nausea and vomiting should rank at the top of your to-do list. Once your patient feels more comfortable, you can move on to other interventions like obtaining blood cultures or discontinuing the CVC if needed.

This approach is not only about quick actions; it’s about creating a cycle of care. Once you’ve helped alleviate one symptom, you can better perform a thorough assessment, keeping the door open for proper follow-up actions. Nurses, you’re not only caregivers but also advocates for comfort and well-being. It’s about finding that balance between addressing acute symptoms and being ready for other necessary interventions.

So next time you’re faced with a patient experiencing similar issues, remember: the smallest actions can lead to promising outcomes. Let’s keep our priorities straight, and ensure that we’re always advocating for our patients’ comfort and safety, particularly in challenging scenarios like managing a central venous catheter.