CVP Monitoring
CVP Monitoring
Prepared ByTrevor Thomas OBJECTIVES At the end of the session
the students will be able to:Define CVP.Discuss the Indication and
Contra-indication.How it is performed.Elaborate the basic
principles.How to write nursing notes.Discuss regarding Waveform on
Monitor.Define Nursing Care.
CVPA Central Venous Catheter (CVC) is an indwelling intravenous
device that is inserted into a vein of the central vasculature.
INDICATIONCentral venous pressure monitoringVolume
resuscitationCardiac arrestLack of peripheral accessPlacement of
transvenous pacemakerCardiac catheterization, pulmonary
angiographyHemodialysis
CONTRA-INDICATIONBleeding disordersAnticoagulation or
thrombolytic therapyCombative patientsDistorted local
anatomyCellulitis, burns, severe dermatitis at siteVasculitis
TECHNIQUE
Use introducing needle to locate veinWire is threaded through
the needleNeedle is removedSkin and vessel are dilatedCatheter is
placed over the wireWire is removedCatheter is secured in place
Basic Principles Decide if the line is really necessary.
Know your anatomy.
Be familiar with your equipment.
Obtain optimal patient positioning and cooperation and take your
time.
Use sterile technique and ask for help.
Always aspirate as you advance as you withdraw the needle
slowly.
Always withdraw the needle to the level of the skin before
redirecting the angle.
Obtain chest x-ray post line placement and review it
Common insertion areasRight internal jugular veinLeft internal
jugularRight subclavianLeft subclavianFemoral
Advantages
&
Disadvantages How to write a NOTE?Name of procedureIndication
for procedureComment on consent, if applicableDescribe what you
did, including prepComment on aspiration/flushing of portsHow did
patient tolerate procedureAny complicationsCVP waveformThe CVP
waveform reflects changes in right atrial pressure during the
cardiac cycle
CVP waveforma wave: Atrial contraction.
c wave: Closure of Tricuspid valve at start of Right ventricular
contraction. x descent: Atrial Relaxation.
v wave: Passive filling of right atrium and vena cava when
tricuspid valve kept closed.
y descent: tricuspid valve opens and blood flows into right
ventricle.
What factors INCREASES and DECREASES CVP?Nursing Care Close
observationVital signHandling of Lines Dressing as per policyPost
removal care Lab checks
