A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurse's highest priority?

Repositioning the client is the appropriate action for the nurse to take, as chest burning may indicate that the chest tube is kinked, twisted, or compressed, which can impair drainage and ventilation. The nurse should gently move the client to a different position and check that the chest tube is not bent or occluded by clothing, bedding, or furniture. The nurse should also ensure that there are no dependent loops or coils in the tubing and that it is secured to prevent dislodgment.

a) Increasing the client's wall suction is not advisable, as it can cause increased negative pressure in the pleural space and lead to tension pneumothorax. Increasing the wall suction does not affect the patency of the chest tube or the drainage of air or fluid from the lung. The nurse should maintain the wall suction at the prescribed level and monitor for any changes in the suction chamber.
c) Clamping the client's chest tube is not advisable, as it can cause air or fluid accumulation in the pleural space and lead to tension pneumothorax. Clamping the chest tube does not relieve chest burning or improve drainage or ventilation. The nurse should only clamp the chest tube for a brief period of time and under specific circumstances, such as changing the drainage system, assessing for an air leak, or preparing for chest tube removal.
d) Stripping the client's chest tube is not advisable, as it can cause increased negative pressure in the pleural space and lead to tissue damage or bleeding. Stripping the chest tube involves applying manual pressure along the tubing to force out any clots or debris that may obstruct drainage. However, this practice is not recommended, as it can cause more harm than good. The nurse should only milk the chest tube gently and intermittently if ordered by the provider and if there is evidence of obstruction.

Smoking cessation is the most effective way to prevent chronic bronchitis, which is a type of chronic obstructive pulmonary disease (COPD) characterized by inflammation and excess mucus production in the

bronchi. Smoking is the main cause of chronic bronchitis, as it damages the cilia and mucous membranes of the airways, leading to chronic cough, sputum, and infection. Quitting smoking can reduce the risk of developing or worsening chronic bronchitis and improve lung function and quality of life.

a) Regular moderate exercise is beneficial for preventing chronic bronchitis, but not as effective as smoking cessation. Exercise can improve cardiovascular and respiratory health, increase oxygen delivery to the tissues, and enhance immune function. However, exercise alone cannot reverse the damage caused by smoking or prevent further deterioration of the airways.
b) Maintenance of ideal weight is beneficial for preventing chronic bronchitis, but not as effective as smoking cessation. Maintaining a healthy weight can reduce the workload on the heart and lungs, prevent obesity-related complications, and improve self-esteem and well-being. However, weight management alone cannot restore the normal structure and function of the airways or prevent chronic inflammation and mucus production.
c) Annual influenza immunization is beneficial for preventing chronic bronchitis, but not as effective as smoking cessation. Influenza immunization can protect against viral infections that can trigger or exacerbate chronic bronchitis symptoms, such as fever, cough, wheezes, and dyspnea. However, influenza immunization cannot prevent other causes of chronic bronchitis, such as bacterial infections, environmental pollutants, or genetic factors.