護理師照護一位新放置周邊置入中心靜脈導管（PICC）的病人。下列哪些發現應立即回報給醫師？（選所有適合的）
A nurse is caring for a client with a new peripherally inserted central catheter (PICC). Which of the following findings should the nurse report to the provider immediately? (Select all that apply.)
- AThe client reports mild discomfort at the insertion site病人報告插入部位有輕微不適
- BThe nurse cannot aspirate blood from the catheter護理師無法從導管抽吸血液
- CThe client develops sudden shortness of breath✓ 正解病人突然出現呼吸困難
- DThere is visible redness and warmth around the insertion site✓ 正解插入部位周圍可見紅腫和發熱
- EThe external length of the catheter has increased✓ 正解導管外露長度增加
PICC 導管照護涉及高度感染控制與血栓預防。正確選項 C、D、E 代表可能致命或嚴重的併發症。呼吸困難（C）暗示空氣栓塞或血栓脫落導致肺栓塞；紅腫熱（D）是導管相關血流感染（CRBSI）的典型臨床表現；導管外露長度增加（E）則顯示導管移位（migration），可能導致輸液外滲或心律不整。護理臨床思路應優先處理威脅生命與感染徵兆，需立即停止輸液並通知醫師。
Care of a PICC requires a high level of infection control and thrombosis prevention. The correct options C, D, and E represent potentially life-threatening or serious complications. Dyspnea (C) suggests an air embolism or a dislodged thrombus causing pulmonary embolism; redness and warmth (D) are classic clinical findings of catheter-related bloodstream infection (CRBSI); and an increase in the external length of the catheter (E) indicates catheter migration, which can cause infusate extravasation or arrhythmia. Clinical reasoning should prioritize life-threatening and infectious signs; the nurse must stop the infusion immediately and notify the provider.
在美國，PICC 導管的置入與移除通常需由經過認證的專業護理師（PICC nurse）或專科醫師執行，護理師監測重點在於觀察位置變化（cm markings）及感染跡象，且美國醫院對 CLABSI 的監測極為嚴格。