A nurse is caring for a client who has just developed a pulmonary embolism. Which of the following medications should the nurse anticipate administering?

Keeping the drainage system below the level of the client's chest prevents backflow of fluid or air into the
pleural space and maintains negative pressure in the system.

a) Disconnecting the chest tube from the drainage system during transport is dangerous and can cause pneumothorax, infection, or bleeding. The chest tube should remain connected to the drainage system at all times unless ordered by the provider.
b) Emptying the collection chamber prior to transport is unnecessary and can interfere with accurate measurement of drainage. The collection chamber should be emptied only when it is full or at the end of each shift.
c) Clamping the chest tube prior to transferring the client to a wheelchair is contraindicated and can cause tension pneumothorax, as it prevents air from escaping the pleural space. The chest tube should only be clamped for a brief period when changing the drainage system or checking for air leaks, and only with a provider's order.

Answer: A

Rationale:

A) Administering a nebulized beta-adrenergic:

In the case of an acute asthma exacerbation, administering a nebulized beta-adrenergic agonist (such as albuterol) is the highest priority. These medications act quickly to relax bronchial smooth muscle, dilate airways, and improve airflow. This intervention directly addresses the underlying bronchospasm and helps to alleviate the acute symptoms of asthma.

B) Providing immediate rest for the client:

While rest is important in managing an acute asthma exacerbation, it is not the immediate priority. Addressing the airway obstruction with appropriate medications is crucial for stabilizing the client's condition before focusing on comfort measures such as rest.

C) Positioning the client in high-Fowler's:

Positioning the client in a high-Fowler's position can help improve lung expansion and facilitate breathing. However, this action is secondary to administering medication that can relieve the acute symptoms of bronchoconstriction. The medication should be administered first to rapidly address the exacerbation.

D) Initiating oxygen therapy:

Oxygen therapy might be necessary if the client shows signs of hypoxemia or severe respiratory distress. However, the immediate priority is to address the bronchospasm with a nebulized beta-adrenergic agonist to improve airflow. Once the acute bronchospasm is managed, oxygen therapy can be implemented if needed to support oxygen saturation.