Page 1841 - Saunders Comprehensive Review For NCLEX-RN

4. Femoral vein catheter

a. Assess the extremity for

circulation, temperature, and pulses.

b. Prevent pulling or disconnecting

of the catheter when giving care.
c. Because the groin is not a clean site,
meticulous perineal care is required.
d. Use an IV infusion pump or controller
with microdrip tubing if a heparin
infusion through the catheter to
maintain patency is prescribed.

The client with a femoral vein catheter

should not sit up more than 45 degrees or lean
forward, because the catheter may kink and
occlude.
B. External arteriovenous shunt (Fig. 54-2)
1. Description
a. Two Silastic cannulas are surgically
inserted into an artery and vein in the
forearm or leg to form an external
blood path.
b. The cannulas are connected to form a U
shape; blood flows from the client’s
artery through the shunt into the vein.
c. A tube leading to the membrane
compartment of the dialyzer is
connected to the arterial cannula.
d. Blood fills the membrane compartment,
passes through the dialyzer, and is
returned to the client through a tube
connected to the venous cannula.
e. When dialysis is complete, the cannulas
are clamped and reattached, reforming
the U shape.
2. Advantages
a. The external arteriovenous shunt can be
used immediately following its
creation.
b. No venipuncture is necessary for
dialysis.
3. Disadvantages
a. Disconnection or dislodgment of the
external shunt

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