The client who has a vascular access device (VAD) complains of chest pain and dyspnea and the nurse assesses for hypoxemia. Which should the nurse prepare to implement?
1. Check client's partial thromboplastin time.
2. Position on the left side with head elevated.
3. Transport client to radiology for a venogram.
4. Maintain a large-bore peripheral IV catheter.
2
2. The client exhibits clinical indicators consistent with an air embolus from the VAD; thus, the nurse prepares to position the client on the left side with the head slightly elevated to keep the embolus from traveling deeper into the lungs because the client is manifesting clinical indicators of an air embolus already. The client could also be experiencing an acute myocardial infarction (AMI) in which case the nurse should position the client for an air embolus until the embolus or AMI are eliminated as diagnoses.
1. If the client deteriorates into critical condition, the provider can prescribe a venti-lation perfusion scan to locate the occlusion from the embolus.
3. Anticoagulation is ineffective therapy for an air embolus.
4. The nurse can prepare to administer supplemental oxygen; large-bore catheters providing IV access in the periphery are contraindicated generally.
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