Question

A client with a peripherally inserted central catheter (PICC) in the right upper extremity suddenly exhibits chest pain, dyspnea, hypotension, and tachycardia. The nurse suspects an embolism related to the PICC line. What should the nurse do?

a. an action that the nurse should take to resolve the problemNon-essential
b. an action that the nurse could take without harming the client, but the action would not be likely to address the problemContraindicated
c. an action that could harm the client and should not be taken

Answer 1

A nurse should immediately stop any infusions through the PICC, elevate the head of the bed, administer oxygen, monitor vital signs, prepare for emergency anticoagulation, and notify the physician. CPR is not initiated unless the patient experiences cardiac arrest.

Step-by-step explanation:

When a patient with a peripherally inserted central catheter (PICC) presents with symptoms of chest pain, dyspnea, hypotension, and tachycardia, a nurse should recognize these as potential signs of an embolism. The nurse's immediate actions are crucial and should focus on stabilizing the patient and seeking immediate medical intervention. The steps include:

• Stop any infusions running through the PICC line.
• Elevate the head of the bed to help improve respiration if the patient can tolerate it.
• Administer oxygen as prescribed to alleviate hypoxia.
• Monitor vital signs and maintain blood pressure to prevent shock.
• Prepare for emergency treatments, which may include anticoagulation therapy.
• Notify the physician immediately for further evaluation and management.
• Do not attempt CPR unless the patient goes into cardiac arrest, as indicated by the absence of pulse and respiration.

These actions are aimed at managing the symptoms and preventing further complications while expert medical interventions are carried out. Actions such as removing the PICC line or giving medications without a physician's order could be contraindicated or cause harm and should be avoided.