AIIMS Delhi NO- 2019
Medical & Surgical Nursing
Medium
The following are the use of the central line catheter; EXCEPT:
Appeared in: AIIMS Delhi NO- 2019
Explanation
- A standard central line catheter's tip resides in the superior vena cava, just proximal to the right atrium.
- This position allows for measurement of pressures related to the right side of the heart (Central Venous Pressure) but not the left side.
- Assessing left ventricular function requires measuring pressures like the Pulmonary Artery Wedge Pressure (PAWP).
- PAWP measurement is accomplished using a Pulmonary Artery (PA) Catheter (Swan-Ganz), which is advanced through the right heart into the pulmonary artery.
- Therefore, a central line catheter is not used to monitor left ventricular function.
Why Other Options Were Wrong
- Option A: This is a primary and common use of a central line catheter. The distal port of the catheter is used to connect to a transducer system to measure Central Venous Pressure (CVP), which helps in assessing fluid status.
- Option B: This is a correct use. Central lines are ideal for administering medications, especially long-term therapies, vesicants (like chemotherapy), or drugs requiring rapid dilution in a large blood volume (like vasopressors).
- Option D: This is a correct use. Total Parenteral Nutrition (TPN) is a highly concentrated solution that is caustic to peripheral veins. It must be administered through a large central vein to ensure rapid dilution and prevent phlebitis.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications for Central Line Catheter Use as background academic context rather than a clinical decision trigger.
- Nurses are responsible for the care and maintenance of central lines, which includes performing sterile dressing changes, flushing the lumens to maintain patency, and monitoring the site for signs of infection (redness, swelling, drainage).
- A critical nursing responsibility is monitoring for and preventing complications such as Central Line-Associated Bloodstream Infections (CLABSI), air embolism (by ensuring all connections are secure and clamping the line when open to air), and thrombosis.
- What if? If a patient's condition deteriorates and requires assessment of cardiac output and left ventricular function, the nurse should anticipate the need for a more advanced line, such as a Pulmonary Artery Catheter, and prepare for its insertion and subsequent monitoring.
How to Approach the Question
- First, identify the keyword 'EXCEPT' in the question stem. This signals that you must find the option that is NOT a function or use of a central line catheter.
- Recall the primary purposes of a central line. Think about what it's used for in a clinical setting: giving fluids/meds, nutrition, and monitoring pressure.
- Evaluate each option based on your knowledge. Ask yourself, 'Is a central line used for this?'
- Option A (CVP monitor): Yes, this is a key function.
- Option B (Administer medication): Yes, this is a very common use.
- Option D (TPN administration): Yes, this is a necessary route for TPN.
Concept Tested & Keywords
- Concept Tested: Indications for Central Line Catheter Use
- Stem keywords: central line catheter, use
- Lead-in keywords: EXCEPT
- Negative lead-in flag: The question uses the word 'EXCEPT', requiring you to identify the incorrect statement among the options.
Question ID
QdX_ZE56bRuqHNGS3AbVpQ
Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 1 Part 2 p. 105-107
E6 Nursing Fundamentals Taylor p. 796-798
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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