Comprehensive Nursing Pharmacology Q 142
A female patient’s central venous access device (CVAD) becomes infected. Why would the physician order antibiotics be given through the line rather than through a peripheral IV line?
A. To prevent infiltration of the peripheral line.
B. To reduce the pain and discomfort associated with antibiotic administration in a small vein.
C. To lessen the chance of an allergic reaction to the antibiotic.
D. To attempt to sterilize the catheter and prevent having to remove it.
Correct Answer: D. To attempt to sterilize the catheter and prevent having to remove it.
Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed.
Option A: CVAD lessens the need for peripheral IV lines and, thus, the risk of infiltration. Broadly, IV therapies can be administered through a peripheral IV access inserted into a vein in the arm during each visit to the chemotherapy unit and removed before the patient returns home, or through central venous access devices (CVADs) such as peripherally inserted central catheters (PICCs) and implanted vascular access devices (“ports”).
Option B: In this case, however, antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has this effect, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent.
Option C: Allergic reaction would not occur. The use of a PICC or port is thought to reduce the risk of extravasation, ensure reliable access for infusion, improve patient satisfaction, and eliminate the long-term effects on peripheral veins that can be damaged by the administration of vesicant drugs. However, CVADs are also associated with an increased risk of thrombotic and infectious complications.