Which of the following represents a key monitoring consideration after initiating umbilical venous catheter placement?

• A. Confirm radiographic placement and monitor for signs of infection, thrombosis, or bleeding.
• B. No imaging is required if the infant is stable.
• C. Monitor only for electrolyte disturbances.
• D. Remove the catheter after 24 hours regardless of position.

Answer: (A)

Key idea after placing an umbilical venous catheter is to verify the tip’s position with imaging and to vigilantly watch for catheter-related complications. Radiographic confirmation is essential because the catheter must sit in a safe central venous location to deliver fluids and medications correctly; if the tip is malpositioned, it can cause organ injury, ineffective therapy, or serious events. Once position is confirmed, ongoing monitoring for infection (fever, signs of sepsis), thrombosis (swelling or changes in perfusion of limbs, catheter dysfunction), and bleeding at the umbilical stump or around the insertion site is crucial. These risks increase with time the catheter remains in place, so continuous assessment is key. Therefore, confirming placement radiographically and monitoring for infection, thrombosis, or bleeding is the best monitoring approach.