Question

explain the potential complication of dysrthmias and pneumothorax/hemothorax associated with central venous access devices and identify nursing interventions aimed at preventing and treating this particular complication.

Answer 1

Answer : Central venous line is a catheter that used to assess central venous pressure ( central venous pressure is the blood pressure in the Vena cavae ,near the right atrium of the heart .CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood back into the arterial system . Veins used for CVS line insertion : internal jugular veins ( neck), chest (subclavian or axillary vein, groin (femoral vein ) , or peripherally inserted central catheters . Complications : 1)pneumothorax (excess air in the plural cavity) : hypoxemic respiratory failure ,respiratory or cardiac arrest , empyema , pneumppericardium, pneumoperitoneum ,bronchopulmonary fistula . 2)  Hemothorax : (it happens when an injury or other factors causes blood to collect in the plural cavity ) collapsed lung, respiratory failure , shock and death in severe cases . 3) Disrhythmias : placement of central venous catheters in patients is associated with several risks including endocardial injury and dysrhythmis. In addition, CVS extending into intracardiac chambers can provoke premature atrial and ventricular complexus,which have been reported reported as supraventricular tachycardia. Nursing interventions for preventing complications : 1) monitor the signs of complications 2) Assess for the patency of the CVP line (observe for kinks, leakage ,gravity ) 3) check whether the the CVP is normal , high or low 4) sterile dressing should be done to prevent infection 5) strictly monitor vital signs including spo2 . 6) flush the catheter frequently according to the doctors advise.