Certified Registered Nurse Infusion (CRNI) Practice Exam

When changing the infusion set on a central vascular access device, what position should the patient be in?

1. Standing

2. Sitting

3. Supine with Valsalva maneuver

4. Lateral position

The correct answer is: Supine with Valsalva maneuver

For changing the infusion set on a central vascular access device, having the patient in a supine position while performing a Valsalva maneuver is particularly important. This position helps to create a negative pressure in the thoracic cavity, which can reduce the risk of air being drawn into the bloodstream during the procedure. The Valsalva maneuver, which involves a patient taking a deep breath and forcefully exhaling with a closed mouth, helps to increase intrathoracic pressure. This action can displace air and enhance venous return, thus preventing any potential complications such as air embolism. While other positions, such as sitting or lateral, may be appropriate in certain situations, they do not provide the same level of safety as the supine position combined with the Valsalva maneuver. The standing position is also not advisable, as it may increase the risk of complications during the procedure. Therefore, placing the patient supine with a Valsalva maneuver offers the best balance of safety and efficacy during the changing of the infusion set.