1 Central Venous Catheter Usage Central Venous Catheter Usage Synethia Harris Walden University NURS 5051A Dr. Debbie Beck December 25, 2017 Informatics has been identified as one of the core competencies for nurses at all levels of practice. Nurses and computer documentation of patients with chronic kidney disease can significantly improve the quality of patient care and treatment. Healthy kidneys regulate the body’s levels of water and mineral and removes waste. I would find the most relevant information through searching the database on issues topicing or having a relationship with dialysis access. I would use search for words such as “dialysis access”, “problems with central venous catheters”, and “femoral venous access”. I would also trace illustrations in books and journals that touch on central venous catheters highlighting femoral access. The kidneys also secrete certain products that are important in metabolism. People with failed or damaged kidneys may have difficulty eliminating waste and unwanted water from the blood. (Fresenius, 2006). The cause might be a chronic, or long-term condition, or an acute problem, such as an injury or a short-term illness that affects the kidneys. Dialysis is an artificial way of carrying out this process. Dialysis substitutes the natural work of the kidneys. It is also known as renal replacement therapy (RRT). Hemodialysis requires access to blood vessels capable of providing rapid extracorporeal blood flow. Immediate hemodialysis access should be straightforward, available for immediate use, and have minimal complications. That is where tunneled central venous catheters (CVCs) come in to play. I am aware of central venous catheters being used as a quicker method of access. During my research, said that femoral sites are associated with high risks of catheter-related bloodstream infections (CRBIs). During hemodialysis, the access site is the patient’s lifeline (Fresenius, 2006). So why is the femoral vein a considered site for surgeons? The use of invasive monitoring technologies and aggressive hemodynamic resuscitation protocols has increased. Therefore, the ability to gain rapid and accurate vascular access has become a skill that is imperative for critical and emergency care physicians to possess. The predictable anatomic locations of the dialysis central venous catheter are the internal jugular, subclavian, and femoral vein. In the last ten years, tunneled central venous catheters (CVCs) have been increasingly utilized in chronic hemodialysis patients, sometimes in the place of fistulas. They have gained popularity for their unquestioned advantages, such as the possibility for immediate use. However, several problems have emerged following their diffusion. Infections, thrombosis and dysfunctions are the most important catheter-related complications. Infections may occur with and without symptoms of systemic illness. Early diagnosis and appropriate antibiotic tre ...

1. 1
Central Venous Catheter Usage
Central Venous Catheter Usage
Synethia Harris
Walden University
NURS 5051A
Dr. Debbie Beck
December 25, 2017

2. Informatics has been identified as one of the core
competencies for nurses at all levels of practice. Nurses and
computer documentation of patients with chronic kidney disease
can significantly improve the quality of patient care and
treatment. Healthy kidneys regulate the body’s levels of water
and mineral and removes waste. I would find the most relevant
information through searching the database on issues topicing
or having a relationship with dialysis access. I would use search
for words such as “dialysis access”, “problems with central
venous catheters”, and “femoral venous access”. I would also
trace illustrations in books and journals that touch on central
venous catheters highlighting femoral access. The kidneys also
secrete certain products that are important in metabolism.
People with failed or damaged kidneys may have difficulty
eliminating waste and unwanted water from the blood.
(Fresenius, 2006). The cause might be a chronic, or long-term
condition, or an acute problem, such as an injury or a short-term
illness that affects the kidneys. Dialysis is an artificial way of
carrying out this process. Dialysis substitutes the natural work
of the kidneys. It is also known as renal replacement therapy
(RRT).
Hemodialysis requires access to blood vessels capable of
providing rapid extracorporeal blood flow. Immediate
hemodialysis access should be straightforward, available for
immediate use, and have minimal complications. That is where
tunneled central venous catheters (CVCs) come in to play. I am
aware of central venous catheters being used as a quicker
method of access. During my research, said that femoral sites
are associated with high risks of catheter-related bloodstream

3. infections (CRBIs). During hemodialysis, the access site is the
patient’s lifeline (Fresenius, 2006). So why is the femoral vein
a considered site for surgeons?
The use of invasive monitoring technologies and
aggressive hemodynamic resuscitation protocols has increased.
Therefore, the ability to gain rapid and accurate vascular access
has become a skill that is imperative for critical and emergency
care physicians to possess. The predictable anatomic locations
of the dialysis central venous catheter are the internal jugular,
subclavian, and femoral vein. In the last ten years, tunneled
central venous catheters (CVCs) have been increasingly utilized
in chronic hemodialysis patients, sometimes in the place of
fistulas. They have gained popularity for their unquestioned
advantages, such as the possibility for immediate use. However,
several problems have emerged following their diffusion.
Infections, thrombosis and dysfunctions are the most important
catheter-related complications. Infections may occur with and
without symptoms of systemic illness. Early diagnosis and
appropriate antibiotic treatment are essential for saving the
catheter. The pathogenesis of infections and strategies for
prevention are many. Thrombosis and stenosis are well known
complications of subclavian and jugular catheterization. In
uremic patients, for temporary use, the use of the femoral vein
is a suggested location site. Protocols for application of
thrombolytic agents in CVCs are considered. Dysfunction,
defined as the failure to maintain a blood flow of at least two
hundred and fifty milliters per minute, remains the Achilles’
heel of the system. Adequate look therapy and tip position are
only two basic aspects.
All routes of central venous access are associated with
complications and possible failure. The less than ideal
conditions under which such access is established also
contribute to the incidence of complications. The technique of
accurately placing a femoral vein catheter depends on
appropriate patient selection and a sound knowledge of
anatomy. A couple of the generally accepted indications for

4. femoral venous catheter placement are urgent or emergency
hemodialysis access and hemoperfusion access in patients with
severe drug overdose.
In 2012, a task force of the American Society of
Anesthesiologists published a set of practice guidelines for
central venous access. Absolute contraindications for femoral
central line placement for patients with venous injury at the
level of the femoral veins or proximally, suspected thrombosis
of the femoral veins on the proposed side of venous
cannulation, and ambulatory patients, because ambulation
increases the risk of catheter fracture and migration.
Other contraindications for femoral central venous access are
the presence of bleeding disorders,
distortion of anatomy due to deformity, previous long-term
venous catherization, absence of a
clearly palpable femoral artery, history of vasculitis, and
history of radiation therapy
In conclusion, informatics can be used to gain wisdom. A
pessimistic outlook on the matter could lead us to consider that
the advantages of catheter use are far outweighed by the
disadvantages. However, we cannot avoid using central venous
catheters in our dialysis units and a great challenge awaits both
physicians and manufactures in the coming years.
References
American Nurses Association. Nursing Informatics: Scope and
Standards of Practice. Silver Spring, MD: nursesbooks.org;
2008.

5. Cheesbrough, J, Finch, R, Burden, R. (1968). A prospective
study of the mechanisms of infection associated with
hemodialysis catheters. Infectious Disease:154-156
Fresenius Medical Care. (2006). Retrieved from: FMC4me.com
Matney, S., Brewster, P. J., Sward, K. A., Cloyes, K. G., &
Staggers, N. (2011). Philosophical approaches to the nursing
informatics data-information- knowledge-wisdom
framework. Advances in Nursing Science, 34(1), 6-18.
McGonigle, D., & Mastrian, K. (2011). Nursing informatics and
the foundation of knowledge Jones & Bartlett Learning.
National Kidney Foundation. KDOQI Clinical Practice
Guidelines for Hemodialysis Adequacy, 2000. Am J Kidney Dis
2001; 37 (suppl 1):S7-S64.
O’Grady, N, Alexander M, Burns, L. (2011). Guideline for the
prevention of intravascular catheter-related infections .162-
193.
Ponikyar, R. (2005). Temporary hemodialysis catheters as a
long-term vascular access in chronic hemodialysis patients
Writing with Research Worksheet
Name:_________________________
Use West Guide pages 359-362 (327-331 in old book) to guide
you in answering the following questions.

6. 1. List the three steps in creating a quote sandwich.
_____________________________________________________
_____________________
_____________________________________________________
_____________________
_____________________________________________________
_____________________
2. What are the two ways an in-text citation can look? Write
two of them from the chapter.
________________________________
________________________________
2. True or False (Circle one): Citations do not need the
abbreviation “p.” or “pp.”
3. What is a signal phrase?
4. Give an example of a signal phrase, making up a sentence
using a signal verb
from the brown box.
5. What is a block quote?

7. 6. Where does the in-text citation go for a block quote?
7. What does the use of ellipses indicate inside a quote?
8. Write a quote from one of our readings or a page in The West
Guide, omit some of the words, and replace them with ellipses.
9. Why might brackets be used inside a quote?
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