08-15-CVP@ - Measuring Central Venous Pressure (CVP) Robie...

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Measuring Central Venous Pressure (CVP) Robie Thomas, MS, RN, AOCN Overview of the Skill Central venous pressure (CVP) is a measure of the pressure within the right atrium of the heart. Central venous pressure measures the ability of the right side of the heart to deal with the systemic fluid load. Central venous pressure changes reflect the client’s overall fluid volume status. A low CVP is an indicator of hypovolemia generally calling for an increase in IV fluids. A high CVP can be caused by hypervolemia or by poor cardiac function. This is usually treated by diuresing the client. Central venous pressure is commonly measured using a pressure transducer attached to a bedside monitor. The transducer must be leveled at the phlebostatic axis. Using a pressure transducer reduces the risk of air embolus while measuring the CVP. Central venous pressure can be measured using a manometer attached to the intravenous fluid line. The CVP is measured in terms of fluid pressure in the column of the manometer. In order to ensure the accuracy of the CVP reading, the manometer must always be positioned in the same place, relative to the right atrium. This spot is called the phlebostatic axis. It is located on the midaxillary line in the fourth intercostal space. Once located, the phlebostatic axis should be marked with ink to assure the accuracy of following measurements. Using the manometer does involve the possible complications of infection and air embolism. Assessment 1. Assess the client’s ability to lie in a supine position without a pillow. This allows the nurse to take a more accurate reading of the CVP.
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2. Assess the client’s vital signs and intake and output. This information will aid the health care team in determining how best to manage the client. Diagnosis 1.2.1.1 Risk for Infection 1.4.1.2.2.2 Risk for Fluid Volume Deficit 1.6.2.1.2.1 Impaired Skin Integrity Planning Expected Outcomes: 1. The client’s CVP will be measured accurately. 2. Aseptic technique will be maintained. 3. The client will not suffer any complications as a result of the CVP measurement. Equipment Needed (See Figure 8-15-2): [Insert Picture 8-15-2] • Sterile gloves • IV tubing • Manometer set or pressure transducer setup • Stopcock, if not included in manometer set • Indelible ink marking pen • Tape • Mask • Normal saline Estimated Time to Complete the Skill:
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5 to 10 minutes Client Education Needed: 1. Explain to the client why it is important to be placed in a supine position without pillow for the measurement. Reassure the client that once the procedure is completed, the client can be placed in a more comfortable position. 2. Explain to the client the importance of leaving the “X” marking the right atrium in place. Reassure the client that once measurements are no longer needed, the mark can be
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This note was uploaded on 10/13/2010 for the course NURS 100 taught by Professor Beneker during the Spring '10 term at Columbus State Community College.

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08-15-CVP@ - Measuring Central Venous Pressure (CVP) Robie...

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