What could be an indicative sign of a CVAD malfunction?

• A. Heat around the site
• B. Persistent resistance during flushing
• C. Patient comfort level
• D. Absence of blood flow only

Answer: (B)

Persistent resistance during flushing is a significant indicative sign of a CVAD (Central Venous Access Device) malfunction. When attempting to flush a CVAD, there should be minimal resistance, allowing for the smooth introduction of saline or medication into the bloodstream. If resistance is consistently felt, it may suggest that there is an obstruction within the catheter or that it is not positioned correctly. This could be due to a kink in the catheter, a thrombus (clot) that has formed within the lumen, or even displacement of the catheter tip. Any of these issues could compromise the effectiveness of the CVAD and put the patient at risk for complications.

In contrast, heat around the site may indicate inflammation or infection rather than a malfunction of the catheter itself. Patient comfort level is subjective and does not directly measure the functionality of the CVAD. Finally, the absence of blood flow alone could be due to a variety of reasons, not solely indicating a malfunction; it’s paramount to assess additional signs and symptoms to identify the precise issue. Therefore, persistent resistance during flushing serves as a critical and objective sign warranting further investigation into the status of the CVAD.