Mr. Colicky, 65 years old, has a central venous catheter. Which nursing intervention is a priority when caring for a client with a central venous catheter?

• A. Assess Mr. Colicky for air embolism
• B. Change the dressing hourly
• C. Flush the line every hour
• D. Discontinue use immediately if any discomfort occurs

Answer: (A)

Air embolism risk is a life-threatening complication with central venous catheters, so the priority is to assess for and respond quickly to signs of air entering the venous system. The nurse should be vigilant for sudden shortness of breath, chest pain, coughing, dizziness, cyanosis, hypotension, tachycardia, or acute anxiety—signs that air may be traveling to the heart and lungs. If air embolism is suspected, immediate actions include placing the patient in the left lateral Trendelenburg position to trap air in the right atrium, administering 100% oxygen, keeping the catheter lumen closed and the line secure, and notifying the physician to initiate further treatment (which may include aspiration of air through the catheter and other emergency measures). This approach directly targets the most dangerous potential complication and can prevent rapid deterioration. Other care steps, such as dressing changes every hour, flushing the line hourly, or discontinuing use at the first sign of mild discomfort, do not address the urgent risk of air entry and are not appropriate primary interventions.