A nurse is monitoring a client who has just had a thoracentesis to remove pleural fluid. Which of the following clinical manifestations should indicate to the nurse the client is experiencing a complication and the provider should be notified immediately?

Choice A reason: Keeping a tongue stud in during surgery poses a risk of aspiration and is not allowed. All body piercings should be removed before surgery to ensure safety.

Choice B reason: Consuming clear liquids up to the time of surgery is not allowed. Clients are typically required to fast for a certain period before surgery to prevent aspiration during anesthesia.

Choice C reason: The correct answer is c because allowing the client to keep her hearing aids in helps facilitate communication until the last possible moment before surgery. This helps reduce anxiety and ensures the client understands preoperative instructions.

Choice D reason: Taking morning vitamins before surgery is not recommended, as clients are usually required to fast. Medications, including vitamins, should be reviewed and managed by the healthcare provider.

Choice A reason: Emptying the collection chamber every 4 hours is unnecessary and can increase the risk of introducing infection. The chamber should be emptied as needed based on the volume of drainage.

Choice B reason: Stripping the chest tube, which involves squeezing and releasing sections of the tube to move clots, is not recommended as it can create high negative pressure and cause damage to the lung tissue.

Choice C reason: Pinning the chest tube to the client’s gown can lead to accidental dislodgement. The chest tube should be secured appropriately without tension.

Choice D reason: The correct answer is d because taping the connections on the client’s chest tube ensures that the system remains airtight and prevents air leaks, which is essential for effective functioning of the chest tube and prevention of pneumothorax recurrence.