When considering a site for placement of a peripheral intravenous catheter in a neonate, the nurse should:

• A. Conserve areas that may later be needed for central line placement
• B. Use the most distal vein first
• C. Always place on the scalp
• D. Avoid any use of peripheral veins

Answer: (A)

In neonates, venous access is precious because their veins are small and can be used up quickly. A central venous catheter may be needed for long-term therapy, irritant medications, or parenteral nutrition, and central lines are placed in specific regions (such as the umbilical, jugular, or subclavian veins) depending on the baby’s age and condition. When choosing where to place a peripheral IV, the nurse should avoid exhausting sites that could be needed for central line placement later. By conserving areas that may be needed for central venous access, you keep future options open and reduce the risk of having to place a central line in a less ideal location after multiple failed peripheral attempts.

Using the most distal vein first can lead to more limited peripheral access later, and scalp veins carry additional risks and aren’t universally preferred. Avoiding peripheral veins entirely neglects the infant’s immediate need for IV therapy.