The Centers for Disease Control and Prevention (CDC) recommends placing a colonized client on contact precautions and in a private room. Colonized clients are at increased risk for infection with MRSA if signs (eg, fever, wound drainage, purulent mucus) are present, treatment is required. If signs of infection are absent, treatment is not required. The nurse should always handle the lumen ports and hubs aseptically with facility-approved antiseptics to prevent catheter-associated infections.Ī: Client with pneumonia who has a positive MRSA nose culture Rationale: A client with a positive nose swab for methicillin-resistant Staphylococcus aureus (MRSA) is colonized and can transmit the bacteria to others. Educational objective: A central venous catheter is used to administer fluids, for simultaneous infusion of incompatible drugs, for parenteral nutrition, and for hemodynamic monitoring. Parenteral nutrition is administered through the IV route via a central vein. (Option 2) Enteral nutrition is given only through the GI tract (orally or through a feeding tube). These are used to administer incompatible drugs simultaneously, for blood draws, and for hemodynamic monitoring. (Option 1) CVCs may have multiple lumens. Always allow the antiseptic to dry before using the hub/port (Option 4). The hubs should be disinfected with a hospital-approved antiseptic (eg, 70% alcohol sterile pads > 0.5% chlorhexidine with alcohol 10% povidone-iodine). The Centers for Disease Control and Prevention recommend that catheter hubs always be handled aseptically to prevent catheter-associated infections. Proper hand hygiene should be performed when caring for a CVC to prevent infection, and nonsterile gloves should be worn to protect the nurse from blood or body fluids at the port site as one or more lumens are often used to draw blood (Option 3). A central line or central venous catheter (CVC) is inserted by the health care provider in a "central" vein (eg, subclavian, internal jugular, femoral) and is used to administer fluids, medications, and parenteral nutrition and for hemodynamic monitoring. The lumen hub should be cleaned thoroughly with antiseptic prior to administration. Assess 2 things: Whether the client can bear weight: Neurological deficits (eg, paralysis, paresis ) Decreased muscle strength (eg, prolonged immobility, multiple sclerosis, muscular dystrophy) Trauma (eg, amputee, hip fracture) Whether the client is cooperative and able to follow instructions: Altered mental status (eg, delirium, drug intoxication) Decreased cognitive ability (eg, dementia, head injury) Use assistive devices when lifting >35 lb (15.9 kg) of client's body weight. Recommended bed-to-chair transfer method Weight bearing Full Independent no assistance required 1-person standby assistance or observation for clients who are uncooperative or at high risk for falls Partial 1-person assist stand & pivot transfer with gait belt or motorized assist device if cooperative 2-person assist with full-body sling if client is uncooperative None Motorized assist device if client is cooperative & has upper body strength 2-person assist with full-body sling if client is uncooperative &/or has no upper body strength Client should use as much of his or her own strength as possible.
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