A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

A. Pigeon

A pigeon chest, also known as pectus carinatum, is a deformity of the chest characterized by a protrusion of the sternum and ribs, resulting in a pigeon-like appearance of the chest. This deformity is not typically associated with COPD.

B. Funnel

A funnel chest, also known as pectus excavatum, is a deformity of the chest characterized by a depression or concavity in the sternum, resulting in a funnel-like appearance of the chest. This deformity is not typically associated with COPD.

C. Kyphotic

Kyphosis refers to an exaggerated forward curvature of the thoracic spine, leading to a hunched or rounded upper back. While individuals with severe COPD may develop kyphosis due to chronic respiratory muscle fatigue and increased work of breathing, kyphotic curvature is not specific to COPD and can occur in other conditions as well.

D. Barrel

In COPD (Chronic Obstructive Pulmonary Disease), the client's chest may take on a barrel shape. This is characterized by an increase in the anterior-posterior diameter of the chest, resulting in a more rounded appearance similar to that of a barrel. This change in chest shape is due to hyperinflation of the lungs, which occurs as a result of air trapping and increased residual volume in the lungs, common in COPD.

A. Add tap water as needed to the suction control chamber.

This is not the correct action. The suction control chamber of a water-seal chest tube drainage system is typically filled with sterile water to the prescribed level by the healthcare provider during the initial setup. Adding tap water to the suction control chamber can disrupt the balance of the system and affect the prescribed suction level. The nurse should not add tap water without specific instructions from the healthcare provider.

B. Maintain the drainage container below the level of the client's chest.

This is the correct action. In a water-seal chest tube drainage system, it's important to keep the drainage container below the level of the client's chest. This positioning allows gravity to assist in the drainage of air or fluid from the pleural space into the drainage container. It also helps prevent backflow of fluid or air into the chest cavity, ensuring the effectiveness of the drainage system.

C. Empty the collection container every shift.

While it may be necessary to empty the collection container if it becomes full, emptying it every shift is not a set rule. The frequency of emptying the collection container should be based on the volume of drainage and the facility's policy. The nurse should monitor the collection container regularly and empty it when it reaches the appropriate level, typically around half full or as indicated by facility protocol.

D. Clamp the chest tubes if it becomes disconnected.

Clamping the chest tubes if they become disconnected is not recommended. It can lead to tension pneumothorax, a life-threatening condition where air accumulates in the pleural space and compresses the lung. If a chest tube becomes disconnected, the nurse should immediately assess the situation, secure the chest tube connections, and notify the healthcare provider for further management.