NCLEX-PN® ExaminationPhysiological AdaptationMedium
A client with a new peripherally inserted central catheter (PICC) line develops sudden shortness of breath, chest pain, and tachycardia. The nurse notes decreased breath sounds on the affected side. The nurse should immediately prepare for interventions to address which complication?
- AAir embolism
- BThrombosis
- CPhlebitis
- DPICC line infection
Show answer & explanationAnswer & explanation
Correct answer: A. Air embolism
The sudden onset of shortness of breath, chest pain, tachycardia, and decreased breath sounds on the affected side in a client with a new PICC line are classic signs of an air embolism, a life-threatening complication where air enters the bloodstream and travels to the heart or lungs. Immediate intervention is required.
Why the other options are wrong
- B. Thrombosis (clot formation) can occur, but typically causes swelling, pain, and discoloration of the extremity, not sudden, acute respiratory symptoms like those described.
- C. Phlebitis is inflammation of the vein, characterized by pain, redness, and swelling along the vein, not sudden respiratory distress.
- D. PICC line infection typically presents with fever, chills, and local signs of inflammation, not sudden respiratory distress and chest pain.
PICC Air Embolism Signs
An air embolism is a serious complication of central venous access, presenting with sudden dyspnea, chest pain, tachycardia, hypotension, and decreased breath sounds, often with a 'mill wheel' murmur.
- Sudden onset of respiratory distress.
- Chest pain, tachycardia, hypotension.
- Can be prevented by proper line management (clamping, Valsalva).
- Immediate action: clamp line, Trendelenburg left side, O2.
Memory trick: PICC Problems: Pushed Air, Infected, Clotted, Collapsed