Download - CVP Report
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Central
VenousPressure
(CVP)
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(CVP) Central Venous
PressureO Is a measure of the pressure within the
right atrium of the heart.
O It measures the ability of the right side ofthe heart to deal with the systemic fluid
load.
O Its changes reflect the clients overall fluid
volume status.
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IndicationsO CVP measurement
O Drug and fluid administration
O Nutrition and feedingO Cardiac pacing
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Other IndicationsO Fluid resuscitation in major trauma
O Cardiac surgery
O Thoracic surgeryO Major abdominal surgery
O To optimize fluid replacement in acute
renal failure
O To optimize fluid replacement duringsepsis
O To guide fluid replacement in heart failure
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Normal CVP= 2-6 mmHg
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CVP is affected by:O Intrathoracic
pressure or
musculoskeletal
pumpO Vascular tone
O Obstruction
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2 Common type of CVP
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O To ensure the
accuracy of the
CVP Reading,
the manometer
must always be
positioned in thesame place,
relative to the
right atrium.
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Nursing Process
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DiagnosisO Risk for infection
O Risk for deficient fluid volume
O Impaired skin integrity
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PlanningO Expected Outcomes:
1. The clients CVP will be measured
accurately.2. The aseptic technique will be
maintained.
3. The client will not suffer any
complications as a result of the CVPmeasurement.
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O Estimated time to complete the skill is 5-
10 minutes
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Implementation
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Insertion phase :
( by physician )1. The CVP site is surgically cleaned
2. Assist the patient to remaining motionlessduring insertion .
3. Monitor for dysrhythmias , tachypnea,tachycardia as catheter threaded to greatveins is connect primed IV tubing tocatheter and allow IV solution to flow .
4. The catheter should be suture in place .
5. Place a sterile occlusive dressing over site.
6. Obtain a chest x-ray.
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Move the manometer scale up and down to
allow the bubble to be aligned with zero onthe scale. This is referred to as 'zeroing the
manometer'.
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O Turn the three-
way tap off to the
patient and open
to themanometer.
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O Turn off theflow from the
fluid bag and
open the three-
way tap from
the manometer
to the patient
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O The fluid level
inside themanometershould fall
until gravityequals thepressure inthe centralveins
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O When the fluid stops falling the CVP
measurement can be read. If the fluidmoves with the patient's breathing, read
the measurement from the lower number.
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O Turn the tap off to
the manometer
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Low CVP reading is caused by
O Hemorrhage
O Excessive dieresis- result of diabetes ordiuretic therapy
O Poor venous return- eg. Cardiogenic
shock
O Peripheral vasodilation- result ofsepticemia or vasodilatory therapy
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Special ConsiderationsO Arrange for daily chest X-rays to check
catheter placement, as ordered.
O Care for the insertion site according to facility
policy.O Change the dressing every 24 to 48 hours.
O Be sure to wash your hands before dressingchanges; use aseptic technique and sterilegloves when redressing the site.
O When removing the old dressing, observe forsigns of infection, such as redness, and notepatient complaints of tenderness.
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O Apply ointment if directed by facility policy,then cover the site with a sterile gauzedressing or a clear occlusive dressing.
O
After the initial CVP reading, reevaluatereadings frequently to establish a baseline forthe patient.
O Authorities recommend obtaining readings at15-, 30-, and 60- minute intervals to establisha baseline.
O If the patients CVP fluctuates by more than 2cm H2O, suspect a change in his clinicalstatus and report this finding to the physician.
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Potential ComplicationsO Haemorrhage
O Catheter
O InfectionO Air Embolus
O Catheter Displacement