Following insertion of a peripheral vascular device, the client complains of shortness of breath, chest pain, and palpitations. The nurse would initially:
1. Place a tourniquet proximal to the site.
2. Notify the physician.
3. Obtain vital signs.
4. Obtain radiographic studies.
Place a tourniquet proximal to the site.
Rationale: If a catheter embolism is suspected, immediate interventions need to be initiated; the nurse would secure a tourniquet on the client's arm to minimize movement of the catheter. Vital signs would need to be obtained after the tourniquet is placed. The physician would need to be notified, but this is not the initial intervention Radiographic studies may be indicated to determine the location of the catheter, but this will be implemented after placement of the tourniquet, notification of the health care provider, and vital signs are obtained.
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