A client who is having a tunneled central venous catheter inserted begins to report chest pain and difficulty breathing. What action does the nurse take first?
a. Administer the PRN pain medication.
b. Prepare to assist with chest tube insertion.
c. Place a sterile dressing over the IV site.
d. Place the client in the Trendelenburg position.
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.
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1. That a mild analgesic be administered. 2. An epidural. 3. A local anesthetic block. 4. Nonpharmacologic methods for pain relief.
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