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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Metabolic alkalosis is characterized by an elevated pH and elevated bicarbonate, which is not consistent with these ABG values.
B. Respiratory alkalosis presents with an elevated pH and decreased PaCO2, opposite of the client's findings.
C. Metabolic acidosis would show a decreased pH with a low bicarbonate level, but this client's bicarbonate is within normal range.
D. Respiratory acidosis is indicated by a low pH and elevated PaCO2 due to hypoventilation, which aligns with the client's ABG values and respiratory rate.
Correct Answer is D
Explanation
A. Holding the client's arms and legs can cause injury and does not help in managing the seizure. The focus should be on protecting the client from harm.
B. Moving the client back to bed during a seizure can be dangerous and increase the risk of injury. It's best to manage the seizure where the client is.
C. Inserting a tongue blade or any object into the client's mouth can cause injury to the teeth or oral cavity and is not recommended during a seizure.
D. Placing the client on his side helps maintain an open airway and prevents aspiration, which is crucial during a seizure to ensure the client’s safety.
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