Surgical Procedure:

Complications of Internal Jugular Vein:

● Arterial puncture
● Hematoma
● Pneumothorax
● Damage to the vein
● Hemothorax
● Air embolism
● Catheter misplacement*
● Arrhythmias or atrial perforation, typically caused by guidewire or catheter
● Nerve damage
● Infection
● Thrombosis

HIGH RISK OF INFECTION. ASSOCIATED COMPLICATIONS; septicemia - blood stream

infection also called blood poisoning. & infective endocarditis

Nursing Management:

● Determine the patient’s health history -allows for early identification of risk factors
for signs and complications that can and symptoms related to CKD.
be associated with CKD (chronic
kidney disease).

● Monitor urine output, assess for signs Creatinine:

of dehydration, and track renal female- 1.45-1.78
function through laboratory tests such Male-1.78-2.32
as serum creatinine and blood urea Note: creatinine also assess the function of
kidney
nitrogen levels (BUN) levels.
Bun:
3.57-7.14
note: pt. attached catheter to help pt. urinate

- It assesses fluid balance and tracks

renal function.
- IF BUN & CREATININE ratio is high =
problem with kidney’s ability to
function
- IF low ratio= indicate reduce hepatic
 urea synthesis ( which may indicate
liver disease) or low protein diet
- Dehydration common complication in
CKD patients, and regular
assessment aids in preventing
complications
Urine findings:
Abnormal urine findings include
Pyuria- high level WBC, too much PUS,
appear cloudly, may indicate sepsis
Hematuria- blood in the urine, may indicate
bladder damage
Proteinuria- presence of high amount of
protein in the urine may be a sign of kidney
disease
Crystalluria-presence of crystals in urine, may
induce kidney problems such as
nephrolithiasis, nephrocalcinosis and
sometimes acute or chronic kidney
impairment able to result in end stage renal
failure.

Maintenance of ideal body weight without - help manage fluid overload, a

excess fluid. Strictly monitor intake and common issue in CKD. reduces the
output of the patient. risk of edema and hypertension, and
promotes overall well-being

- It allows for early detection of any

Note the amount, color and time of day changes in the patient's condition.
diuresis occurs. Monitor vital signs every 30 Given the potential for fluid and
minutes. electrolyte imbalances in CKD,
frequent assessment helps identify
trends or acute changes, enabling
timely intervention.
- it helps prevent fluid imbalances, fluid
overload Amber, honey-colored or
even Dark urine means dehydration

Ensure the patient's vascular access site, - To prevent invasion of bacteria and
especially if using an internal jugular (IJ) prevent complications
catheter, is clean, intact, and free from signs
of infection.
 - These measures enhance comfort,
● Assist the patient in position changes prevent complications such as
in bed and advise to elevate the legs pressure ulcers, and contribute to
when sitting. overall mobility and well-being.

- Edema is a common manifestation of

● Assess for edema and weigh the fluid imbalance in CKD. Regular
patient daily. assessment and daily weighing help
identify changes in fluid status,
allowing for timely interventions to
prevent complications such as
congestive heart failure and
respiratory distress.

- Regular monitoring allows healthcare

● Monitor the wound for any signs of
deterioration or worsening infection.
providers to detect signs of infection
at an early stage and prevents the
infection from worsening and
potentially spreading to other areas of
the body.

- Educating the patient and family about

● Educate the patient and family about signs of excess fluid will help
signs of excess fluid. recognize associated complications
that may worsen

● Educate the importance of dietary -helps manage hypertension, fluid retention,

restrictions and lessen sodium intake and prevents complications associated with
CKD progression.

-Many individuals may not be familiar with

● Provide patients and their families leptospirosis, its transmission, and the
associated risks. Providing education raises
with a comprehensive education on
awareness about the disease, helping
leptospirosis prevention. patients and their families understand its
nature, symptoms, and potential
consequences.

● Provide a supportive and positive --enhances the patient's confidence,

attitude regarding abilities.. encourages active participation in self-care,
and positively influences overall well-being,
adherence to treatment plans, and coping
with the challenges of living with CKD.