A nurse is caring for a client who has a chest tube in place connected to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client's lung has re-expanded?

Choice A reason: A fractured femur, while a serious injury, does not inherently contraindicate the use of lipid emulsions. These patients may require additional nutrition if they are unable to eat adequately by mouth, and lipid emulsions can be part of their parenteral nutrition regimen if needed.

Choice B reason: Severe anorexia nervosa is a condition that can lead to malnutrition and may necessitate the use of parenteral nutrition, including lipid emulsions, to provide essential nutrients. However, care must be taken to avoid refeeding syndrome, a potentially fatal condition that can occur when malnourished patients begin to refeed too quickly.

Choice C reason: Gastrointestinal obstruction is a condition that could be exacerbated by the administration of lipid emulsions. In cases of obstruction, enteral or parenteral nutrition may need to be carefully managed or avoided until the obstruction is resolved to prevent further complications. While lipid emulsions are a valuable component of parenteral nutrition, their use must be carefully considered in the context of the patient’s overall clinical condition. In the case of gastrointestinal obstruction, the nurse would be most concerned about the prescription of a lipid emulsion due to the potential for exacerbating the obstruction and complicating the patient’s condition.

Choice D reason: Chronic diarrhea and vomiting can lead to dehydration and electrolyte imbalances, but they do not directly contraindicate the use of lipid emulsions. However, the underlying cause of these symptoms should be addressed, and fluid and electrolyte balance should be carefully monitored.

Title: Choice A reason: Liver enzymes Liver enzymes are proteins that speed up chemical reactions in your body. They include alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP). High levels of liver enzymes in the blood can indicate liver disease. However, rheumatic endocarditis is a heart condition, not a liver condition. Therefore, while liver enzymes are important for diagnosing liver conditions, they would not assist in confirming a diagnosis of rheumatic endocarditis.

Title: Choice B reason: Serum albumin Serum albumin is a type of protein that your liver and kidneys produce to help your body maintain fluid balance and function. Low or high albumin levels can indicate liver disease, kidney disease, or nutritional deficiency. However, rheumatic endocarditis is a heart condition, not a liver or kidney condition. Therefore, while serum albumin is important for diagnosing liver and kidney conditions, it would not assist in confirming a diagnosis of rheumatic endocarditis.

Title: Choice C reason: Throat culture A throat culture is a lab test used to find and identify germs in the back of your mouth that are making you sick. It can diagnose infections like strep throat, gonorrhea, thrush, diphtheria, and pertussis. Rheumatic endocarditis is often caused by a streptococcal infection, which can be identified through a throat culture. Therefore, a throat culture would assist in confirming a diagnosis of rheumatic endocarditis.

Title: Choice D reason: Arterial blood gases An arterial blood gas (ABG) test measures the levels of oxygen and carbon dioxide in your blood as well as the pH balance in your blood. It helps diagnose and monitor conditions that affect your respiratory, circulatory, and metabolic systems. However, rheumatic endocarditis is a heart condition that is often caused by a bacterial infection. Therefore, while an ABG test is important for diagnosing conditions that affect your respiratory, circulatory, and metabolic systems, it would not assist in confirming a diagnosis of rheumatic endocarditis.