Trauma Certified Registered Nurse (TCRN) Practice Exam

The most appropriate action after placing a right internal jugular line is to verify placement with a chest x-ray. This step is crucial because it helps confirm that the catheter is positioned correctly within the superior vena cava and not accidentally misplaced in the lungs or pleural space. Verification through imaging ensures that there are no complications such as pneumothorax or misplacement that could arise from the procedure.

While administering intravenous fluids may be necessary soon after placement, doing so without confirmation of correct line placement poses a risk of delivering fluids into a misplaced catheter, which could lead to severe complications. Obtaining an ultrasound for confirmation could be useful in some contexts, particularly if there’s suspicion of an issue or if the placement has been difficult, but it does not serve as the primary method of verification after line placement. Finally, beginning central line use without verification is strongly discouraged, as it can result in significant patient harm.

Therefore, obtaining a chest x-ray is the standard practice to ensure the safety and efficacy of the internal jugular line before proceeding with its use.