A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications?

Administer an expectorant

Perform range-of-motion exercises

Place suction equipment at the bedside

Encourage the use of an incentive spirometer

Answer and Explanation

The Correct Answer is D

A. Administering an expectorant is not primarily aimed at preventing pulmonary complications but rather at helping to clear mucus. While this can be part of respiratory care, it does not address the prevention of complications like atelectasis or pneumonia.

B. Performing range-of-motion exercises is important for overall mobility and prevention of deep vein thrombosis but does not specifically address the prevention of pulmonary complications.

C. Placing suction equipment at the bedside is useful for managing secretions but does not directly prevent pulmonary complications. It is a reactive measure rather than preventive.

D. Encouraging the use of an incentive spirometer is an effective method to prevent pulmonary complications such as atelectasis and pneumonia. It helps improve lung function by promoting deep breathing and expanding the alveoli.

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Correct Answer is D

Explanation

A. Eyelets not being visible may be a normal finding, as they can be covered by the dressing. This is not necessarily indicative of a problem with the chest tube.

B. Crepitus, or subcutaneous emphysema, is concerning and should be monitored but is not immediately life-threatening compared to other signs of complications.

C. Bubbling in the water seal chamber with exhalation is expected and indicates that the chest tube is functioning correctly. Continuous bubbling, however, may suggest an air leak.

D. Movement of the trachea toward the unaffected side is indicative of a mediastinal shift, which can occur due to tension pneumothorax or other significant complications. This is an urgent condition that requires immediate provider notification and intervention.

A. Polyphagia B. Dehydration C. Hyperglycemia D. Bradycardia

Correct Answer is B

Explanation

A. Polyphagia (excessive hunger) is typically associated with diabetes mellitus, not diabetes insipidus. Diabetes insipidus primarily affects fluid balance rather than blood sugar levels.

B. Dehydration is a common finding in diabetes insipidus due to the inability to concentrate urine, leading to excessive fluid loss and potential dehydration.

C. Hyperglycemia is associated with diabetes mellitus rather than diabetes insipidus. Diabetes insipidus does not directly affect blood glucose levels.

D. Bradycardia (slow heart rate) is not a typical finding in diabetes insipidus. The primary concern in diabetes insipidus is fluid imbalance rather than heart rate issues.

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A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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