Question

A nurse is caring for a patient with a central venous pressure (CVP) catheter.

·     What are the key nursing responsibilities of managing a central venous pressure catheter?

·     What position must the nurse place the patient to read the central venous pressure correctly?

Answer 1

Nursing responsibility of managing CVP catheter

• Once the central venous pressure catheter inserted the dressing is to be kept dry and air occlusive. Dressing changes are performed with the use of sterile technique.
• Catheter placement is confirmed by a chest x-ray, after insertion.
• Catheter site is inspected daily for signs of infection, redness or any discharge.
• The dressing and pressure monitoring system are changed according to hospital policy.
• Any handling of the line should be kept to a minimum to reduce the risk of contamination and the line should be securely fastened to the patient.
• CVP catheters can be used for infusing intravenous fluids, administering intravenous medications, and drawing blood specimens in addition to monitoring pressure. So always follow aseptic technique, hand hygiene to avoid infection.
• The most common complications of CVP monitoring are infection and air embolism. So take precaution while handling the CVP line.
• CVP must be measured, zeroed at a specific interval as per condition of the patient and keep record, also maintain the patency of the CVP catheter.

Patient position to read Central venous pressure.

CVP can be measured through manual or elecronic method. In either case the CVP must be ‘zeroed’ at the level of the right atrium. This is usually taken to be the level of the 4th intercostal space in the mid-axillary line , the phlebostatic axis while the patient is lying flat in supine position. Each measurement of CVP should be taken at this same position. This is the ideal position to get the accurate data.