A nurse is assisting with the care of a client who has a chest tube. Which of the following actions should the nurse take?
Strip the client's chest tube every 2 hours.
Loop the tubing of the chest tube on the client's bed.
Place the chest tube drainage system above the level of the client's heart.
Tape the connections on the client's chest tube.
The Correct Answer is D
Choice A reason: Stripping the client's chest tube every 2 hours is not a recommended action, as it can cause excessive negative pressure, tissue trauma, and pain. The nurse should only strip the chest tube if there is a clot or obstruction in the tubing, and only with the provider's order.
Choice B reason: Looping the tubing of the chest tube on the client's bed is a correct action, as it prevents kinking, tension, or pulling on the chest tube. The nurse should also secure the tubing to the bed sheet with a safety pin.
Choice C reason: Placing the chest tube drainage system above the level of the client's heart is not a correct action, as it can cause the fluid to flow back into the chest cavity and impair lung expansion. The nurse should place the chest tube drainage system below the level of the client's chest.
Choice D reason: Taping the connections on the client's chest tube is a correct action, as it prevents air leaks, disconnections, or accidental removal of the chest tube. The nurse should also check the connections regularly for tightness and patency.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Spinach is a good source of potassium, but not the best. According to the USDA, one cup of cooked spinach contains 839 mg of potassium, which is about 18% of the recommended daily intake (RDI) for adults².
Choice B reason: Baked potato is the best source of potassium among the choices. According to the USDA, one medium baked potato with skin contains 941 mg of potassium, which is about 20% of the RDI for adults². Potassium is an essential mineral that helps regulate fluid balance, nerve and muscle function, and blood pressure.
Choice C reason: Banana is a popular source of potassium, but not the best. According to the USDA, one medium banana contains 422 mg of potassium, which is about 9% of the RDI for adults².
Choice D reason: Cheese is a poor source of potassium. According to the USDA, one ounce of cheddar cheese contains only 28 mg of potassium, which is less than 1% of the RDI for adults². Cheese is high in sodium, which can counteract the benefits of potassium and increase the risk of hypertension.
Correct Answer is B
Explanation
Choice A reason: Metabolic alkalosis is a condition in which the blood pH is elevated due to an excess of bicarbonate or a loss of acid. It can be caused by vomiting, diuretics, or excessive antacid intake. It is not associated with COPD.
Choice B reason: Respiratory acidosis is a condition in which the blood pH is lowered due to an accumulation of carbon dioxide. It can be caused by hypoventilation, airway obstruction, or lung diseases such as COPD. It is the most common acid-base imbalance in COPD patients.
Choice C reason: Respiratory alkalosis is a condition in which the blood pH is elevated due to a loss of carbon dioxide. It can be caused by hyperventilation, anxiety, fever, or aspirin overdose. It is not common in COPD patients.
Choice D reason: Metabolic acidosis is a condition in which the blood pH is lowered due to an excess of acid or a loss of bicarbonate. It can be caused by diabetic ketoacidosis, renal failure, or lactic acidosis. It is not directly related to COPD.
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