Question

a client who has just had a triple - lumen catheter placed in their right subclavian vein reports chest pain and shortness of breath. the clients blood pressure is decreased from baseline and, on auscultation of their chest, the nurse notes unequal breath sounds. a chest x - ray is immediately ordered by the health care provider. what diagnosis should the nurse suspect?pneumothoraxpulmonary embolismmyocardial infarction (mi)heart failure

Explanation:

• Pneumothorax: Insertion of a central line (like triple - lumen catheter in subclavian vein) can cause pneumothorax. Symptoms include chest pain, shortness of breath, unequal breath sounds, and decreased BP (due to respiratory compromise).
• Pulmonary embolism: Usually presents with sudden dyspnea, chest pain, but is more related to blood clots (often from deep vein thrombosis), and unequal breath sounds are not a typical primary sign here.
• Myocardial infarction: Presents with chest pain (often radiating, associated with ECG changes, elevated cardiac markers), not typically unequal breath sounds after central line insertion.
• Heart failure: Presents with dyspnea, edema, crackles, etc., not related to central line insertion and unequal breath sounds.

Answer:

A. Pneumothorax