A nurse is caring for a client who is comatose and requires a non-life-threatening surgical procedure. Which of the following actions should the nurse take?

A. Clean the insertion site with betadine: While povidone-iodine (Betadine) can be used, current guidelines recommend using chlorhexidine for central line site care because it is more effective in preventing catheter-related bloodstream infections. Using betadine is not the preferred standard of care.

B. Flush the catheter with sterile water: Central venous catheters should be flushed with sterile saline, not sterile water, to maintain patency and avoid hemolysis or electrolyte imbalance. Flushing with water can damage blood cells and the catheter.

C. Use a 5-mL syringe to flush the catheter: A minimum of a 10-mL syringe is recommended when flushing a central venous catheter because smaller syringes generate excessive pressure that can damage the catheter. Using a 5-mL syringe increases the risk of catheter rupture.

D. Wear sterile gloves when providing site care: Sterile technique is required when performing central line site care to prevent infection. Wearing sterile gloves protects the client from pathogens and is a critical step in maintaining asepsis during dressing changes and catheter maintenance.

A. High Fowler's: High Fowler’s position can assist with respiratory effort and comfort, but it does not specifically optimize cardiac output in a pregnant client. Upright positioning alone may not relieve pressure from the gravid uterus on major vessels.

B. Left lateral: Placing the client in the left lateral position relieves pressure of the uterus on the inferior vena cava and aorta, enhancing venous return to the heart and improving cardiac output. This position is especially important in clients with cardiac disease to reduce the risk of supine hypotensive syndrome and optimize maternal and fetal circulation.

C. Standing: Standing does not provide support for venous return and can increase the workload on the heart, potentially exacerbating cardiac compromise. It is not recommended for prolonged periods in clients with cardiac disease during pregnancy.

D. Supine: Supine positioning can compress the inferior vena cava and aorta, reducing venous return and cardiac output. This can lead to hypotension and decreased perfusion to both the mother and fetus, making it unsafe for pregnant clients with cardiac disease.