Nursing Performance Checklist Central Venous Pressure

_________________________: Student Name : Purpose . a. To serve as guide for fluid replacement .b. To monitor pressure in the right atrium and central veins c. To administer blood products, TPN and drug therapy contraindicated for . peripheral infusion .d. To obtain venous access when peripheral veins sites inadequate . e. To insert a temporary pacemaker . f. To obtain central venous blood sampler :Equipment CVPkit-1 Flush system composed of intravenous solution [ contain heprain],tubing -2 ,stopcocks and flush device Pressure bag place around the flush solution is maintained 300 mmgh pressure , -3 pressurized flush system delivers 3 to 5 ml solution per hours through cathter to . prevent clotting .Transducer to convert the pressure from right atrium into electrical signal -4 . Monitor which increase size of signal for display on oscilloscope-5 .IV pole -6 Done Not done : Steps of procedure complete incomplete : For insertion . Explain the procedure to patient -1 (Position patient appropriately . ( supine position -2 .Flush IV infusion set and manometer -3 .Place ECG monitoring-4 . The CVP site is surgically cleaned*-5 Assist the patient to remaining-6 . motionless during insertion Monitor for dysrhythmias ,tachypnea, *-7 . tachycardia as catheter is threaded to great veins Connect primed IV tubing to catheter and allow -8 .IV solution to flow . The catheter should be suture in place* -9 .Place a sterile occlusive dressing over site -10 .Obtain a chest x-ray *-11

Cont : steps of procedure complete To measure CVP : . Place the patient in supine position -1 Position the zero point of the manometer should -2 .be on level with the patient right atrium Turn the stopcock so the IV solution -3 flow into manometer ,to about 20 25 cm level . And the turn stopocock so the solution .in manometer flow to the patient Record the level the at which the solution -4 stabilizes. This CVP reading CVP catheter connect to transducer and electrical -5 . monitor with CVP wave readout CVP may range from 5 to 12 cmH2O of -6 .or 2 to 6 mm Hg . Assess patient condition -7 Turn the stopcock again to allow IV -8 solution to follow to patient veins and should . monitor infusion hourly phase : Follow-up . Prevent and observe for complication -1 . a. From catheter insertion : pneumothorax hemothorax , air embolism . hematoma .and cardic temponade , b. From indwelling catherer : infection .air embolism, central venous thrombosis Make sure cap is secure -2 If air embolism is suspected , immediately place -3 patient in left lateral trendelenburg position and administer O2. 4- Carry out ongoing nursing intervention of the :insertion site and maintain aseptic technique a. Inspect site twice daily for signs of local inflammation and phlebitis , Remove the catheter . immediately if there are signs of infection b. Make sure sutures are intact .c. Change dressing as prescribed .d. label to show date and time of change . e. Send the catheter tip for bacteriological culture incomplete

: Cont Steps of Procedure Complete incomplete When discontinued , remove -5 .central line .a. Position patient flat with head down .b. Remove dressing and suture .c. Have patient take deep breath d. Apply pressure at catheter site e. Monitor site and vital signs for signs of bleeding .or hematoma formation

______________________________ : Supervised by _________________________________ : Comments .steps done by physician *

Miss Aisha Alhofaian,2008