Nursing Prioritization Delegation Assignment Q 7
The nurse is caring for four clients receiving IV infusions of normal saline. Which client is at the highest risk for bloodstream infection?
A. A client who has a non-tunneled central line in the left internal jugular vein.
B. A client with an implanted port in the right subclavian vein.
C. A client with a peripherally inserted central catheter (PICC) line in the right upper arm.
D. A client who has midline IV catheter in the left antecubital fossa.
Correct Answer: A. A client who has a non-tunneled central line in the left internal jugular vein
Central lines are associated with a higher infection risk, the skin of the neck and chest have high numbers of microorganisms, and the line is non-tunneled: such factors increase the risk for infection. About half of nosocomial bloodstream infections occur in intensive care units, and the majority of them are associated with intravascular devices. Central-venous-catheter-related bloodstream infections (CRBSIs) are an important cause of healthcare-associated infections.
Option B: Implanted ports are placed under the skin and so are less likely to be associated with catheter infection than a non-tunneled central IV line. Inflow obstruction (7.6%) and infection (6.9%) were the main complications, followed by reflux (3.1%), subcutaneous masses (1.5%) and fistulae (1.5%). The median interval between port implantation and port complication was 5.4 months (range: 0.3–40.9 months).
Option C: A peripherally inserted central catheter (PICC) infection occurs when bacteria enters the bloodstream through or around a central line catheter . A PICC is a long, thin tube that is inserted through a vein in the arm.
Option D: Midline catheters are associated with a lower incidence of infection. Midline catheters (MCs) are peripheral IV access devices that may reduce the need for central lines and hence decrease central line-associated bloodstream infections.