A nurse starts an IV medication for a client. It is ordered as IV push, and she pushes the medication slowly over two minutes. The client then becomes restless, complains of chest pain, has difficulty breathing, and becomes cyanotic. The nurse recognizes this is most likely caused by

  1. an allergic reaction to the drug.
  2. pneumothorax.
  3. septic shock.
  4. pulmonary embolism.
Number 4 is correct.
Pulmonary embolism is a possible risk of IV therapy. It is caused by air accidentally being pushed into a vein via an IV. If the air embolism travels to the lung, a dangerous pulmonary embolism can occur. Other signs and symptoms can include hypotension, confusion, stroke, and heart failure. The nurse would be alerted to the most likely cause based on her recent intervention. Septic shock and pneumothorax both have additional symptoms that develop over a longer period of time. While an allergic reaction to the medication given is possible, chest pain would be unlikely.