The nurse is caring for a patient with pneumonia and fulminant pulmonary arterial hypertension. The patient is intubated and mechanically ventilated receiving inhaled nitric oxide (iNO). Additionally, the patient has a central line with multiple continuous infusions, including norepinephrine, vecuronium, morphine, and propofol. During the shift, the nurse begins to have difficulty breathing, a dry throat, syncope, and chest pain. Which action does the nurse take first?

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Ensure iNO tubing connections are secure. Healthcare staff caring for patients receiving inhaled nitric oxide are at risk for exposure to the drug. It can cause difficulty breathing, dry throat, syncope, headache, and chest pain. Therefore, the nurse should ensure there are no leaks from the iNO tubing. It is possible the patient is contagious and has infected the nurse, but this is unlikely due to the patient&rsquo;s intubated status. If symptoms persist after fixing the iNO leak, the nurse should be evaluated. Accidental exposure to vecuronium or norepinephrine would not cause the nurse&rsquo;s symptoms.

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