A nurse is caring for a client following a left lobectomy for lung cancer. The nurse should prioritize which of the following interventions to prevent atelectasis?

Obtain pulse oximetry every two hours.

Teach the client how to use the incentive spirometer.

Instruct the client to practice abdominal breathing.

Encourage oral fluid intake of 2000 mL/24 hours.

Answer and Explanation

The Correct Answer is B

A. Obtain pulse oximetry every two hours: While monitoring oxygen saturation is important in assessing respiratory status, it is not a direct intervention for preventing atelectasis. It is more of an assessment tool to evaluate the effectiveness of interventions aimed at preventing atelectasis.

B. Teach the client how to use the incentive spirometer: Incentive spirometry is a valuable tool for preventing atelectasis postoperatively by promoting deep breathing and lung expansion. Teaching the client how to use the incentive spirometer and encouraging its frequent use can help maintain lung volume and prevent collapse of alveoli.

C. Instruct the client to practice abdominal breathing: While abdominal breathing can be beneficial for promoting relaxation and reducing anxiety, it is not as effective as incentive spirometry in preventing atelectasis postoperatively.

D. Encourage oral fluid intake of 2000 mL/24 hours: Adequate hydration is important for overall health and respiratory function, but it is not specifically targeted at preventing atelectasis. While hydration can help maintain airway secretions thin, it is not the primary intervention for preventing atelectasis after a lobectomy.

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Correct Answer is D

Explanation

A. Grilled chicken, white rice, sliced peaches: While grilled chicken is a lean protein source, white rice is low in fiber and may not be the best choice for someone experiencing severe diarrhea. Sliced peaches are a good fruit choice, but the meal lacks sufficient fiber and other nutrients.

B. Spaghetti with tomato sauce, meatballs, and garlic bread: This meal contains high-fat and high-carbohydrate foods, which may exacerbate diarrhea. Tomato sauce can be acidic and irritating to the digestive system for some individuals.

C. Fried shrimp, cauliflower, yogurt with granola: Fried foods are high in fat and may worsen diarrhea. Cauliflower is a good vegetable choice, but yogurt with granola may not be well- tolerated if the client is lactose intolerant or sensitive to dairy products.

D. Grilled salmon, brown rice, broccoli: Grilled salmon provides lean protein and omega-3 fatty acids, which can be beneficial for overall health. Brown rice is higher in fiber compared to white rice and can help regulate bowel movements. Broccoli is a good source of fiber and essential nutrients. This meal is well-balanced and nutritious, making it a suitable choice for someone experiencing diarrhea.

A. "When the doctor comes to see you, we can talk about whether you will need a transplant." B. "Kidney transplantation is likely, and it would be a good idea to start talking to family members." C. "No, don't think that. You're going to be fine in a few weeks." D. "Your condition can be reversed with prompt treatment and usually will not destroy the kidney."

Correct Answer is A

Explanation

A. "When the doctor comes to see you, we can talk about whether you will need a transplant." This response acknowledges the client's concerns and opens the door for further discussion with the healthcare provider about the client's prognosis and potential need for a kidney transplant. It provides an opportunity for the client to receive accurate information from the appropriate healthcare professional.

B. "Kidney transplantation is likely, and it would be a good idea to start talking to family members." This response may cause unnecessary anxiety and speculation for the client without

confirmation from the healthcare provider. It is important to provide information based on the client's specific situation and medical assessment.

C. "No, don't think that. You're going to be fine in a few weeks." This response provides false reassurance and does not address the client's concerns or the potential seriousness of acute kidney injury. It is essential to provide honest and accurate information to the client.

D. "Your condition can be reversed with prompt treatment and usually will not destroy the kidney." While acute kidney injury can sometimes be reversible with prompt and appropriate treatment, it is not always the case. Additionally, it does not address the potential need for a kidney transplant, which depends on the severity and underlying cause of the kidney injury.

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