CENTRAL VENOUS PRESSURE
NCM 118: CRITICAL CARE NURSING (SKILLS)
BS Nursing | SEM 1 2022
CENTRAL VENOUS PRESSURE
- Measure of the pressure within
the right atrium of the heart. It
measures the ability of the right
side of the heart to deal with the
systemic fluid load
- Low CVP is an indicator of
hypovolemia
- High CVP can be caused by
hyperkalemia or poor cardiac
function
CVP CAN BE MEASURED
1. A transducer
2. Use of manometer attached to the
intravenous fluid
PHLEBOSTATIC AXIS
- Located at the right atrium at the
mid axillary line about one-third of
the distance from the anterior to
the posterior chest wall in the
fourth intercostal space
SPECIAL CONSIDERATION
❖ CVP reading: The patient must
always be positioned in the same
place, relative to the right atrium
when measurement is performed
❖ Patient lie in supine position without
a pillow
❖ Position should be documented to
ensure that all nurses caring for the
patient perform measurement in the
same manner
COMPLICATION
- Infection
- Air embolism
PROCEDURES
(Action & Rationale)
1. Wash hands.
Reduces transmission of microorganism
2. Wears gloves and wear mask
Practice aseptic technique
3. Gather equipment needed
● Sterile gloves
● Manometer set/transducer
● Marking pen indelible ink
● Mask
● Normal saline
● Tape
● IV tubing
● Stopcock
Maximizes efficiency and minimizing the
chance of breaking sterility once started
4. Position the client a supine or flat
position if this is not tolerated and
the client is placed in semi-fowler's
positions.
Take all measurements at the same
angle. Mark the right atrium with an
“X” using indelible ink pen
(phlebostatic axis) to identify the
level of the atrium
The manometer should always be zeroed
at the “X”: to minimize variance in
measurements.
5. Connect the IV fluid to a three-way
stopcock and flush the other two
parts. (Normal Saline)
Forces air out of the stopcock. Fluids with
glucose are sticker and should be avoided
6. Connect the CVP manometer to the
upper port of the stopcock
Inserts the CVP manometer into the central
1
CENTRAL VENOUS PRESSURE
NCM 118: CRITICAL CARE NURSING (SKILLS)
BS Nursing | SEM 1 2022

line entering the fluid column or the

7. Connect the CVP tubing from the
client to the second side port of the
stopcock
Establish IV line from normal saline to CVP
catheter
client and to prevent contamination
of the manometer
The top of the manometer is open to the
air. If the manometer is not properly stored,
contaminations or air can enter the
manometer and be flushed into the client.

8. Allow normal saline to drip rapidly 14. Wash hands

into client for few seconds, with
stopcock close to manometer Prevent the spread of microorganism

Establishes that the CVP line is patent. 15. Document reading

Fluids must flow freely for reading to be
accurate Provides continuity of care

9. Turn stopcock off to client and fill

manometer with normal saline to
the 20-cm mark above the
anticipated reading

The normal CVP reading varies from 5 to

12 cm of water

10. Hold manometer at the phlebostatic

axis and turn the stopcock off to the
normal saline

System is open from the manometer to the

patient

11. Watch as the fluid falls in the

manometer. Take the CVP reading
when the fluid stabilizes

The fluid stabilizes at a level equal to the

pressure in the central veins or right atrium.
If the fluid level fluctuates with the client’s
respirations, take the reading at the end of
client’s respirations

12. Turn the stopcock off to the

manometer

Re-establishes fluid flow from the IV to the

client

13. Store the manometer in an upright

position(usually hanging from the IV
pole) to prevent air bubbles from