A nurse is caring for a client diagnosed with lung carcinoma and scheduled for a left pneumonectomy. The nurse should prioritize which nursing Intervention in the immediate postoperative period?

A. Respond to ventilator alarms: While it is crucial to respond to ventilator alarms promptly to ensure the client’s safety and adequate ventilation, this action is not the highest priority in relation to the use of neuromuscular blockers. The use of neuromuscular blockade requires a broader focus on the patient's overall care and safety.
B. Report the absence of spontaneous respirations: Reporting the absence of spontaneous respirations is important, as neuromuscular blockers can cause paralysis of the respiratory muscles. However, the focus should be on maintaining the client's safety and comfort while they are on mechanical ventilation, rather than just reporting findings.
C. Provide passive range-of-motion exercises: This is the priority action when caring for a client receiving neuromuscular blockers. Since the client cannot move voluntarily due to the effects of the neuromuscular blockade, passive range-of-motion exercises are essential to prevent complications such as contractures and muscle atrophy. This intervention helps maintain joint mobility and circulation, which is critical in patients who are mechanically ventilated for an extended period.
D. Encourage the client to attempt to breathe on their own: Encouraging the client to breathe on their own is not appropriate when they are receiving neuromuscular blockade, as their respiratory muscles are paralyzed. Instead, the focus should be on ensuring that the mechanical ventilation settings are adequate to provide proper oxygenation and ventilation while the client cannot initiate breaths independently. This action could lead to respiratory distress if attempted while under neuromuscular blockade.

A. "I feel frustrated when you interrupt me. It's important for us to take turns speaking during client discussions." This response demonstrates assertive behavior because it expresses the nurse's feelings directly and respectfully while addressing the specific behavior that is problematic. By focusing on "I feel" statements, the nurse communicates personal feelings without blaming or attacking the colleague. This approach encourages a constructive dialogue and promotes a more collaborative working relationship.
B. "If you keep interrupting me, I'll report you to our supervisor for disciplinary action." This response is not assertive; it is more aggressive and threatening. It shifts the focus from the behavior to a punitive action and can escalate conflict rather than fostering a constructive conversation. It may create defensiveness in the colleague and is unlikely to resolve the underlying issue.
C. "You always interrupt me when I'm talking. Can't you see how disrespectful that is?" This response is accusatory and confrontational, which is not assertive behavior. While it addresses the behavior, it does so in a way that may cause the colleague to become defensive or hostile. Effective assertiveness involves expressing feelings and needs without assigning blame or using harsh language.
D. "I can't work with someone who constantly takes over conversations. You need to find another partner." This statement is dismissive and aggressive, effectively shutting down communication rather than encouraging teamwork. It does not allow for resolution or discussion of the behavior, making it counterproductive in promoting effective collaboration. Assertive communication should focus on addressing issues while maintaining a willingness to work together.