A nurse is caring for a client following a cardiac catheterization that was inserted through the femoral artery. While turning the client, the nurse discovers ecchymosis underneath the clients lower back. Which priority action would the nurse initiate?

A. Obtain a STAT electrocardiogram: While monitoring cardiac status is important, ecchymosis under the lower back following femoral artery catheterization indicates possible bleeding at the insertion site. Immediate hemostatic intervention takes priority over EKG monitoring. B. Remove the closure device and assess the incision: The closure device should not be removed by the nurse, as this could worsen bleeding or disrupt vascular repair. Only trained personnel following strict protocol can manage or remove the device. C. Reposition the client to semi-fowlers: Semi-fowler positioning may improve comfort or respiratory function, but it does not address the active concern of potential bleeding from the femoral artery site. Immediate pressure is needed to prevent hemorrhage. D. Apply manual pressure over the closure device: Ecchymosis on the lower back may indicate retroperitoneal bleeding from the femoral artery. Applying firm, manual pressure over the insertion site is the priority intervention to control bleeding, prevent further blood loss, and stabilize the client while notifying the provider for urgent assessment.