Practice Question
Client admitted with central venous catheter.
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Rationale:
💠 The presence of redness, tenderness, and swelling extending 2 cm strongly indicates local catheter-site infection.
💠 Ultrasound showing a localized fluid collection supports a diagnosis of infection rather than phlebitis or thrombosis.
💠 The provider ordered vancomycin, confirming suspicion of a bacterial process requiring antibiotic therapy.
💠 Monitoring site changes every 2 hours aligns with early detection of worsening infection or progression to CLABSI.
💠 Assessing temperature is essential because early infection may be afebrile but can progress to systemic involvement.
Phlebitis
💠 Phlebitis presents with streaking along the vein, pain, and warmth, but not usually fluid collection on ultrasound.
💠 Antibiotics are not first-line treatment for uncomplicated phlebitis.
Extravasation
💠 Extravasation involves vesicant leakage into tissue and often causes blistering—not the case here.
💠 Ultrasound would show infiltrated IV fluid rather than infectious collection.
Thrombosis
💠 Thrombosis would cause edema and decreased blood return but not redness spreading or fluid collection.
💠 Pain is usually deeper and less erythematous.
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This question is from ATI PN Fundamentals IV Fluids & Central Line Management Exam which contains 46 questions.
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ATI PN Fundamentals IV Fluids & Central Line Management Exam
46 Questions
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- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: Fundamentals of Nursing
- Answer Choices: 0