Final answer:
The client should generally be in the Trendelenburg position for central line insertion and removal to reduce the risk of air embolism and to facilitate venous access. They should perform the Valsalva maneuver when removing the line to prevent air from entering the circulatory system. Additionally, maintaining sterile technique is crucial to prevent infections.
Step-by-step explanation:
For the insertion and removal of a central line or during a tubing change, it is generally recommended that the client be for central line insertion in the Trendelenburg position or supine with a slight head down tilt if not contraindicated by the patient's condition. This position uses gravity to assist in reducing the risk of air embolism and to increase venous distention, which can make the vessel easier to cannulate. When a central line is being removed, the client should be instructed to perform the Valsalva maneuver, which usually means to take a breath, hold it, and bear down, or to exhale against a closed glottis; this helps prevent air from entering the circulatory system during line removal. Additional instruction involves maintaining sterile technique and meticulous hand hygiene to reduce the risk of infection.
During these procedures, the clinician might also perform auscultation to monitor heart and breath sounds. Proper positioning and breathing techniques can help clinicians detect any complications that may arise, such as pneumothorax or hemothorax during the line placement or removal.