measuring central venous pressure CVP

Preparation:

1. check physician's order and client care plan for measuring CVP.
2. Prepare equipment.
3. discuss procedure with client.
4. provide privacy.
5. lower side rails on working side of bed.
6. place client in horizontal {supine}position.
7. raise bed to appropriate working height.
8. mark an "x" with the indelible pen at the level of the right atrium.

Procedure:

1. wash hands.
2. don gloves.
3. connect the intravenous fluids to the three-way stopcock and flush the other two ports with the fluids.
4. connect the CVP manometer to the upper port of the stopcock.
5. allow IV fluid to drip rapidly into patient for several seconds,with stopcock closed to manometer.
6. turn stopcock off to patient and fill manometer with fluid.
7. hold manometer at "x" on thorax and turn stopcock off to IV fluids.
8. observe the oscillated fluid in manometer with the client's respiration.
9. take reading of CVP
   
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10. turn stopcock off to manometer.
11. remove manometer from stopcock,place sterile dead-end cap on upper part of stopcock and at connector site of CVP.
12. remove gloves.
13. return the patient to comfortable position.
14. lower bed,and raise side rails.
15. wash hands.
16. record in nurses' notes and or on flow sheet the CVP reading.
17. report any abnormal values to the nurse in charge or physician.

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