A nurse is caring for a client who has a three-chamber closed chest tube system. Which of the following actions should the nurse take after noticing a rise in the water seal chamber with client inspiration?

Immediately notify the provider.

Clamp the chest tube near the water seal.

Continue to monitor the client.

Reposition the client toward the left side.

Answer and Explanation

The Correct Answer is C

Continuing to monitor the client is the appropriate action for the nurse to take, as a rise in the water seal chamber with client inspiration is a normal and expected finding. The water seal chamber acts as a one-way valve that allows air to exit from the pleural space and prevents air from entering. The water level in this chamber ﬂuctuates with breathing, rising with inspiration and falling with expiration. This indicates that the chest tube system is functioning properly and that there is no air leak.

a) Immediately notifying the provider is not necessary, as a rise in the water seal chamber with client inspiration is not an abnormal or urgent finding. The nurse should only notify the provider if there are signs of complications, such as persistent bubbling in the water seal chamber, which indicates an air leak, or no ﬂuctuation in the water level, which indicates an obstruction or resolution of pneumothorax.
b) Clamping the chest tube near the water seal is not advisable, as it can cause increased pressure in the pleural space and lead to tension pneumothorax. Clamping the chest tube should only be done 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) Repositioning the client toward the left side is not helpful, as it does not aﬀect the water level in the water seal chamber. The nurse should position the client according to their comfort and condition, and avoid placing them ﬂat or on their aﬀected side, as this can impair drainage and ventilation.

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Correct Answer is ["A","B","D"]

Explanation

Answer: A, B D

Rationale:

Albuterol is a bronchodilator, and one of its key effects is to relax the muscles around the airways, which helps prevent wheezing. Wheezing is often caused by narrowed airways, and by opening them, albuterol helps to prevent this sound, which is associated with asthma or other respiratory conditions.
B. The medication will decrease coughing episodes:
Albuterol can help decrease coughing in individuals with conditions like asthma or chronic obstructive pulmonary disease (COPD) by relaxing the muscles in the airways, which reduces airway constriction. Since coughing often occurs due to airway obstruction, albuterol’s bronchodilator effect can help alleviate this symptom.
C. The medication will reduce inflammation: Albuterol does not have anti-inflammatory properties. Its primary mechanism is bronchodilation, and anti-inflammatory treatment generally requires corticosteroids, not beta-agonists like albuterol.
D. The medication will open the airways:
This is correct. Albuterol works as a bronchodilator, meaning it opens up the airways by relaxing the smooth muscles surrounding them. This improves airflow and makes breathing easier, which is why it is often used in conditions like asthma or COPD.
E. The medication will stimulate flow of mucus: Albuterol does not stimulate mucus production; it primarily works by relaxing the airways. However, by improving airflow, it can help clients more effectively expel mucus through coughing.

Correct Answer is ["A","D"]

Explanation

These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.

b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on coughing, which is a reﬂex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inﬂammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking ﬂuids, using a humidifier, or taking an expectorant.
c) The medication will reduce inﬂammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inﬂammatory eﬀect on the airways, which are often inﬂamed and swollen in clients who have asthma or COPD. Inﬂammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inﬂammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inﬂammation.
e) The medication will stimulate ﬂow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate ﬂow of mucus, such as drinking ﬂuids, using a humidifier, or taking an expectorant.

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A nurse is caring for a client who has a three-chamber closed chest tube system. Which of the following actions should the nurse take after noticing a rise in the water seal chamber with client inspiration?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

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