A nurse is caring for a client who is having a subclavian central ...

[frankwu]

A nurse is caring for a client who is having a subclavian central venous catheter inserted. The client begins to report chest pain and difficulty breathing. After administering oxygen, which action should the nurse take next?
 
  a. Administer a sublingual nitroglycerin tablet.
  b. Prepare to assist with chest tube insertion.
  c. Place a sterile dressing over the IV site.
  d. Re-position the client into the Trendelenburg position.

Question 2

A nurse teaches a client who is being discharged home with a peripherally inserted central catheter (PICC). Which statement should the nurse include in this client's teaching?
 
  a. Avoid carrying your grandchild with the arm that has the central catheter.
  b. Be sure to place the arm with the central catheter in a sling during the day.
  c. Flush the peripherally inserted central catheter line with normal saline daily.
  d. You can use the arm with the central catheter for most activities of daily living.

[Animal_Goddess]

Answer to Question 1

ANS: B
An insertion-related complication of central venous catheters is a pneumothorax. Signs and symptoms of a pneumothorax include chest pain and dyspnea. Treatment includes removing the catheter, administering oxygen, and placing a chest tube. Pain is caused by the pneumothorax, which must be taken care of with a chest tube insertion. Use of a sterile dressing and placement of the client in a Trendelenburg position are not indicated for the primary problem of a pneumothorax.

Answer to Question 2

ANS: A
A properly placed PICC (in the antecubital fossa or the basilic vein) allows the client considerable freedom of movement. Clients can participate in most activities of daily living; however, heavy lifting can dislodge the catheter or occlude the lumen. Although it is important to keep the insertion site and tubing dry, the client can shower. The device is flushed with heparin.