A nurse is preparing to place a peripherally inserted central catheter (PICC) into the arm of a 2-year-old child. The child's mother says, "I thought you said this was a 'central' line? Why are you putting this into her arm?" Which response from the nurse is correct?

 

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Correct

- A central line begins in the arm and is guided into a central location, ending at the heart.

- Do you remember that the doctor said a PICC line is inserted into a vein in your arm? Let me explain it again.

- This is technically not a central line, because a central line is inserted into the chest area.

- A central line begins in the arm and is guided into a central location, terminating in the right ventricle.

Rationale

"A central line begins in the arm and is guided into a central location, ending at the heart." is correct. A peripherally inserted central catheter (PICC) is a type of central line that is inserted in a peripheral extremity, typically one of the arms, and threaded through the vessel so that the end is near the great vessels of the heart. In this manner, although it is inserted peripherally, it is still a central line that can stay in place for longer than a peripheral IV and can be used for medications and solutions that require central line placement.
"Do you remember that the doctor said a PICC line is inserted into a vein in your arm? Let me explain it again." is incorrect, because although the information is technically correct, it is said in a demeaning tone. The healthcare team must always treat patients and family members professionally and with respect.
"This is technically not a central line, because a central line is inserted into the chest area." is incorrect because central lines can be inserted in an extremity and terminate centrally.
"A central line begins in the arm and is guided into a central location, terminating in the right ventricle." is incorrect because if the central line terminates in the right ventricle, it has been advanced too far. The central line should terminate in the superior vena cava or the right atrium.

References:
Peripherally Inserted Central Catheters And Midline Catheters - What You Need to Know. (n.d.). Retrieved April 19, 2018, from https://www.drugs.com/cg/peripherally-inserted-central-catheters-and-midline-catheters.html

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