When assessing a client with a spinal cord injury, the nurse notes areflexia below the level of injury. What should the nurse suspect?

A. Aspirate from the catheter using a 60 ml syringe: Aspiration can introduce infection or damage the catheter if done routinely. It is not the first-line action for slow drainage during peritoneal dialysis. Safer interventions should be attempted first.

B. Flush the catheter with 50 mL of additional dialysate: Flushing may force fluid and increase intra-abdominal pressure, potentially causing discomfort or complications. It is not recommended as an initial step to improve drainage.

C. Advance the catheter 2 to 4 cm further into the peritoneal cavity: Manipulating the catheter manually can increase the risk of trauma or infection. Catheter position is generally fixed, and adjustments should be made only under provider guidance.

D. Reposition the client to facilitate drainage: Changing the client’s position, such as turning from side to side or elevating the head of the bed, often helps the dialysate flow freely. This is a safe and effective first action to relieve slow drainage and prevent complications like fluid retention or abdominal distention.

A. right-sided tension pneumothorax: Tracheal deviation away from the affected side, hypotension, tachycardia, and tachypnea are classic signs of tension pneumothorax. Since the trachea deviates to the left, the problem is on the right side. This is a life-threatening emergency requiring immediate decompression.

B. fall chest with sternal involvement: Flail chest from sternal or rib fractures causes paradoxical chest movement and respiratory distress, but tracheal deviation is not a typical finding. Hypotension may occur with associated injuries, but it does not explain the observed tracheal shift.

C. left-sided tension pneumothorax: A left-sided tension pneumothorax would push the trachea to the right, not to the left. The direction of tracheal deviation helps localize the affected side. This does not match the client’s presentation.

D. fractured ribs with splinting of the chest wall: Rib fractures can cause pain and shallow breathing, but they rarely cause tracheal deviation or severe hypotension. Splinting alone does not account for the hemodynamic instability or mediastinal shift seen in tension pneumothorax.