A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

A. Flush the PICC line with 0.9% sodium chloride after medication administration: This is essential to maintain patency and prevent occlusion as it helps clear any medication residue from the line and ensures proper blood flow.

B. Monitor for a pneumothorax following insertion of the PICC line: A pneumothorax is a potential complication following the insertion of a central venous catheter in the subclavian or internal jugular vein, not typically associated with PICC line insertion.

C. Use a 3 mL syringe when flushing the PICC line: A 10 mL or larger syringe is recommended. Using a 3 mL syringe could generate high pressure, causing damage to the PICC line or the vein, leading to complications such as catheter rupture or vein injury.

D. Expect the PICC line to be inserted into a lower extremity vein: PICC lines are typically inserted into veins in the upper extremities, such as the basilic or cephalic veins. Inserting a PICC line into a lower extremity vein can increase the risk of complications such as DVT.

A. Ketorolac 30 mg IV: Ketorolac is a NSAID that can be administered intravenously for postoperative pain relief. Since the client is only 2 hours postoperative and reports severe pain (10/10), this prescription is appropriate for managing acute pain effectively.

B. Oxycodone 10 mg PO: Oxycodone is an opioid but it is taken orally, which may not be appropriate in the immediate postoperative period when the client is still recovering from anesthesia and may have nausea or difficulty swallowing.

C. Acetaminophen 1,000 mg PO: Acetaminophen is an appropriate medication for mild to moderate pain, but given the client's severe pain (10/10), a stronger analgesic such as an NSAID (ketorolac) or opioid would likely be prescribed in this situation.

D. Fentanyl 12.5 mcg/hr transdermal: Fentanyl transdermal patches are used for long-term, chronic pain management and are not suitable for immediate postoperative pain. The onset of action is slow, and it would not provide adequate pain relief in the immediate postoperative period.