# A nurse is caring for a patient who had an inferior vena cava filter insertion. What is the most critical assessment finding that requires immediate reporting after IVC filter insertion?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=177057  
> language: ko  
> subject: Adult Health

## 문제

A nurse is caring for a patient who had an inferior vena cava filter insertion. What is the most critical assessment finding that requires immediate reporting after IVC filter insertion?

![문제 이미지](https://mymerci.kr/data/question_img/ai/qn177057_20260518_225943_1378.webp)

## 보기

1. Sudden onset of severe back pain with hypotension **✔ 정답**
2. Mild bruising at the insertion site
3. Patient reports feeling anxious about the procedure
4. Temperature of 99.2°F (37.3°C) 24 hours post-procedure

**정답: 1**

## 해설

Sudden severe back pain with hypotension suggests IVC filter migration or perforation, a life-threatening emergency requiring immediate intervention. Mild bruising, anxiety, and low-grade fever are common or less urgent findings.

## 심화 해설

Correct Answer: 1. Sudden onset of severe back pain with hypotension

The most critical post-procedural complication following inferior vena cava (IVC) filter insertion is retroperitoneal hemorrhage, which manifests as the sudden onset of severe back pain accompanied by hypotension. This presentation indicates active, life-threatening bleeding into the retroperitoneal space, requiring immediate intervention.

Understanding the Clinical Priority

The IVC is a large retroperitoneal structure. During percutaneous insertion, the access needle or introducer sheath can inadvertently perforate the venous wall. Because the IVC is located in the retroperitoneum, bleeding from a perforation is not immediately visible externally. Instead, blood accumulates in the retroperitoneal space, which can hold a large volume of blood. The combination of severe back pain (from tissue distension and nerve compression) and hypotension (indicating significant volume loss and hemodynamic instability) is the classic clinical picture of this emergency. This directly aligns with the high-risk nature of IVC procedures, where vascular injury is a known, albeit uncommon, complication. The provided literature on IVC filter retrieval techniques [1] underscores that even with advanced retrieval methods, procedural complications involving the caval wall are a significant concern, reinforcing the need for vigilant post-procedure assessment for signs of hemorrhage.

Analysis of Incorrect Options

Option 2: Mild bruising at the insertion site

A small amount of ecchymosis or a small hematoma at the puncture site (typically in the neck or groin) is an expected finding after any percutaneous vascular procedure. It results from minor capillary disruption during needle entry and does not signify a deep, life-threatening bleed. This is a localized and self-limiting issue, not a systemic emergency.

Option 3: Patient reports feeling anxious about the procedure

Anxiety is a common and understandable psychosocial response to an invasive procedure. While the nurse should address the patient's concerns with therapeutic communication and education, this is a psychosocial need, not a physiological emergency. It does not take priority over a finding that suggests active hemorrhage and hemodynamic compromise.

Option 4: Temperature of 99.2°F (37.3°C) 24 hours post-procedure

A low-grade temperature elevation within the first 24 hours after a procedure can be a non-infectious, inflammatory response to tissue trauma. While it requires continued monitoring, a temperature of 99.2°F (37.3°C) is not a critical value that signals an immediate emergency. The priority is to first rule out life-threatening hemorrhagic shock, as indicated by the correct answer. The implementation of tracking systems, as discussed in the literature [2], aims to improve long-term follow-up and retrieval rates, highlighting that the immediate post-procedural period is focused on acute complications like bleeding, while issues like infection are a later concern.

## 임상 시나리오

IVC Filter Post-Procedure EmergencyRecognizing Retroperitoneal Hemorrhage
The most critical post-procedural complication is retroperitoneal hemorrhage from caval wall perforation. It presents with the classic triad of sudden severe back pain, hypotension, and tachycardia.

Bleeding into the retroperitoneal space is not visible externally. The space can hold over 3 liters of blood, rapidly leading to hemorrhagic shock. Immediate reporting and intervention are required.

CautionDo not dismiss severe back pain as musculoskeletal. In the context of recent IVC filter insertion, it is a vascular emergency until proven otherwise. Assess vital signs immediately and notify the provider.

## 핵심 개념

- **Retroperitoneal Hemorrhage** — Bleeding into the retroperitoneal space, often presenting with severe back pain and hypotension, a critical complication of IVC filter insertion.
- **Inferior Vena Cava (IVC) Filter** — A device placed in the inferior vena cava to trap emboli and prevent pulmonary embolism, inserted percutaneously.
- **Hypotension** — Abnormally low blood pressure, a key sign of hemodynamic instability due to significant volume loss from internal bleeding.

## 같은 주제 문제

- [A nurse is assessing a patient who had an inferior vena cava (IVC) filter placement. Which…](https://mymerci.kr/pages/nclex_q.php?qn_id=177049)
- [Following the insertion of an inferior vena cava (IVC) filter, which assessment finding sh…](https://mymerci.kr/pages/nclex_q.php?qn_id=177050)
- [A nurse is caring for a client who had an inferior vena cava (IVC) filter inserted. Which …](https://mymerci.kr/pages/nclex_q.php?qn_id=177054)
- [A 58-year-old client with a history of deep vein thrombosis had an inferior vena cava (IVC…](https://mymerci.kr/pages/nclex_q.php?qn_id=177055)

---

More free questions: [기출문제](https://mymerci.kr/)

_학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요._