To which patient does the nurse most likely anticipate administering total parenteral nutrition (TPN)?

The patient who has taken phenytoin for the past 12 years for seizure disorder reports feeling something strange in the mouth. The nurse anticipates observing which condition? 

The 21-year-old patient with a body mass index of 10.1 undergoes placement of a peripherally inserted central catheter (PICC) at 1000 and total parenteral nutrition (TPN) is initiated at 1200. At 1600, 160 mL have infused and the patient is noted to be breathing shallowly, there is blood oozing from the PICC insertion site, and the patient is exhibiting confusion. Which action does the nurse perform first?