After the insertion of a central venous catheter for total parenteral nutrition, the patient demonstrates dyspnea with complaints of chest pain radiating to the back

Question

Which of the following should the nurse suspect is occurring with this patient? 1. catheter fracture
2. arterial puncture
3. air emboli
4. pneumothorax

Answer 1

4

Rationale: Pneumothorax is caused by the puncture or laceration of the pleura on insertion of the needle/catheter. Common symptoms include shortness of breath, restlessness, hypoxia, and chest pain radiating to the back. Catheter fracture would not typically occur upon insertion but occur over time. Arterial puncture would be indicated by a flashback of arterial blood in the syringe, pulsatile blood flow, bleeding from the catheter site or development of a large hematoma, and hypotension. Signs and symptoms of an air emboli vary with the amount of air pulled into the venous system but may include respiratory distress, tachycardia, hypotension, sudden cardiovascular collapse, neurologic deficits, or cardiac arrest.