The nurse is discontinuing a central venous catheter. Which of the following steps should be taken?

Instruct the patient to take a deep breath and hold it.
Position patient in Trendelenburg''s position.

Explanation

•Arterial air emboli are more dangerous than air in the venous system. Steps are taken to increase central venous pressure (CVP), which is normally lower in blood vessels that are above the level of the heart and also during inspiration.

•The patient should be placed in the Trendelenburg position with a downward tilt of 10 to 30 degrees. This is to promote venous filling and raise CVP and ensure that the catheter exit site (e.g., neck, arm) is lower than the height of the patient’s heart. If not possible, supine position is sufficient. 

•Instruct the patient to hold his or her breath and perform a Valsalva maneuver (bear down).

•Flushing the catheter with heparin prior to removal is unnecessary.

Visit our website for other NCLEX topics now!