A nurse is collecting data from a client who is taking propranolol. The nurse should monitor the client for which of the following adverse effects?

A. "I will have general anesthesia during the procedure.": Thoracentesis is performed using local anesthesia to numb the puncture site, not general anesthesia. Local anesthesia allows the client to remain awake, follow breathing instructions, and reduce procedural risk associated with systemic sedation. General anesthesia is unnecessary and increases potential complications.

B. "I will lie flat for 6 hours following the procedure.": After a thoracentesis, clients are generally encouraged to resume normal positioning as tolerated, often sitting upright or semi-Fowler’s position. Prolonged flat positioning is not required and does not prevent complications. Monitoring focuses on respiratory status and observing for pneumothorax.

C. "I will have a chest x-ray following the procedure.": A post-procedure chest x-ray is standard to confirm lung re-expansion and to check for complications such as pneumothorax or hemothorax. This imaging ensures that the lung has not been punctured or collapsed during fluid removal, and it guides further management if abnormalities are detected.

D. "I will breathe deeply through my nose during the procedure.": Clients are usually instructed to sit upright and remain still, with occasional breath-holding at end-inspiration during needle insertion. Breathing deeply through the nose is not a standard instruction and may increase movement, risking needle trauma to lung tissue.

A. Preinteraction phase: This phase occurs before the nurse meets the client and involves gathering information, reviewing the client’s history, and planning care. Problem-solving with the client is not addressed in this phase, as there is no direct interaction yet.

B. Working phase: The working phase is when the nurse and client actively collaborate to achieve identified goals. Helping the client develop problem-solving skills, coping strategies, and behavioral changes occurs during this phase, as it focuses on interventions and progress toward therapeutic outcomes.

C. Orientation phase: During the orientation phase, the nurse establishes trust, defines the nurse–client relationship, and sets initial goals. While assessment and goal setting occur, active problem-solving skill development has not yet begun.

D. Termination phase: The termination phase involves concluding the nurse–client relationship, reviewing achievements, and preparing the client for independence. Problem-solving has typically already been addressed in the working phase; this phase focuses on closure rather than skill development.