The patient with a central venous catheter develops substernal chest pain, hypotension, and cough. There is evidence of air in the line. Which action does the nurse take first?

Clamp the catheter. An air embolism is difficult to detect, but has potentially devastating consequences. If the nurse suspects an air embolism, the first action is to clamp the catheter, which prevents more air from entering the vasculature. Next, the nurse places the patient in the left lateral decubitus position, which helps keep the air from reaching the brain’s blood vessels. Intubation is not helpful in this instance as the patient is ventilating properly—the blood is not being oxygenated because of air in the pulmonary circulation. However, the patient may require intubation if circulatory collapse occurs secondary to air embolism. No lab tests are helpful in diagnosing air embolism. Arterial or venous blood gases are not needed urgently.

The patient with a central venous catheter develops substern...

Category: Reduction of Risk Potential
Difficulty: 6

Topics: Cardiovascular Crisis Management Respiratory Delegation, Prioritization and Leadership Medication and Blood Products Nursing Interventions Routes of Administration

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