A nurse is preparing to assist the provider with a thoracentesis for a client who has a left pleural effusion. Which of the following interventions is the priority for the nurse?
Describe the sensations the client will feel during the procedure.
Reinforce the importance of lying still during the procedure.
Administer a sedative medication.
Determine whether the client has an allergy to local anesthetics.
The Correct Answer is D
The priority intervention for the nurse is to determine whether the client has an allergy to local anesthetics, as this could cause a serious adverse reaction during the procedure.
Thoracentesis is a minimally invasive procedure that involves inserting a needle into the pleural space to drain excess fluid or air from around the lungs. The procedure requires local anesthesia to numb the area where the needle is inserted. Therefore, it is essential to assess for any allergy to local anesthetics before proceeding with the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A platelet count of 95,000/mm is below the normal range of 150,000 to 400,000/mm and indicates thrombocytopenia, which increases the risk of bleeding during surgery. The nurse should report this value to the surgeon and anticipate interventions such as transfusion of platelets or postponement of surgery. The other values are within normal limits and do not require immediate attention.
Correct Answer is B
Explanation
The nurse should instruct the clients to limit engaging in sport activities that can cause bruising, as radiation therapy can cause thrombocytopenia and increase the risk of bleeding. The nurse should also encourage the clients to increase their fluid intake, eat a balanced diet that includes fresh fruits and vegetables, and protect their skin from sun exposure. The nurse should not advise the clients to limit socializing in large crowds, unless they have a low white blood cell count and are at risk of infection.
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