What should be the nurse's first action if a patient with an arterial line starts to show signs of distal ischemia?

The first action the nurse should take when a patient with an arterial line shows signs of distal ischemia is to flush the line with saline. This action is critical because it helps to ensure that the arterial line is patent and functioning properly. Distal ischemia can occur if there is a blockage or clotted line, preventing adequate blood flow and leading to potential complications such as limb ischemia.

Flushing the line can immediately restore blood flow and help alleviate the ischemic symptoms. This is a practical and necessary step to confirm that the line is not obstructed before proceeding with further interventions. Taking this action can provide rapid relief and prevent further ischemic damage.

While calling a physician or removing the arterial line may be necessary steps later on, flushing the line is a direct and immediate response that addresses the potential cause of the ischemia. Repositioning the patient's arm might be beneficial in certain contexts, but flushing the line directly addresses the issue at hand more effectively.