Final answer:
A nurse managing a patient with a PICC line should use a noncoring needle for medication administration, flush the PICC line with 10 mL of normal saline before and after, and carefully remove and replace dressings. Strict aseptic technique must be used to prevent infection, and if there is no blood return, the nurse should ensure patency is restored before administering medications, possibly using a slow infusion of heparinized saline if required.
Step-by-step explanation:
To manage a patient with a peripherally inserted central catheter (PICC), the nurse should understand several key aspects of PICC line care. First, it's essential to use an appropriate technique during medication administration and line maintenance. For medication administration, a nurse should use a noncoring needle, flushing the PICC line with 10 mL of normal saline before and after medication administration. This helps to maintain patency and prevent occlusion of the catheter. If the PICC line dressing needs to be replaced, the nurse should carefully remove the old dressing by pulling towards the insertion site to minimize the potential for catheter displacement or contamination. It's crucial to adhere to strict aseptic technique to reduce the risk of infection. If there is no blood return when aspirating the cathic line, the nurse should not administer medication until patency is restored and should follow protocols such as using a slow infusion of heparinized saline, if part of the institution's policy, to clear the line. However, some institutions have moved towards using non-heparin flush solutions due to potential complications associated with heparin.