A nurse is reviewing the laboratory results of a client who is taking furosemide and notes the client's potassium level is 3.0 mEq/L. Which of the following physiological responses should the nurse expect related to the client's hypokalemia?

(A) Place the client in high-Fowler’s position and encourage the use of incentive spirometer and coughing: This is the most appropriate action. The high-Fowler’s position can help improve lung expansion and gas exchange, while the use of an incentive spirometer and coughing can help clear secretions and improve ventilation. This is particularly important for a client who is postoperative following an open thoracotomy.

(B) Switch oxygen to a nonrebreather mask: Switching to a nonrebreather mask may deliver a higher concentration of oxygen, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions.

(C) Position the client prone and have the respiratory therapist perform postural drainage: While postural drainage can help clear secretions, it may not be comfortable or safe for a client who is 1 day postoperative following an open thoracotomy.

(D) Increase oxygen to 70%: Increasing the oxygen concentration may improve the client’s oxygen saturation, but it does not address the underlying issue of impaired gas exchange due to decreased lung expansion and retained secretions. Furthermore, excessively high concentrations of oxygen can have harmful effects, such as oxygen toxicity or suppression of the respiratory drive in some clients.

(A) "A heating pad will be used on the operative site to help reduce pain.":
Using a heating pad on the operative site is generally not recommended post-surgery, as it can increase bleeding and swelling. Cold therapy is usually preferred to help reduce pain and inflammation.

(B) "You will use a continuous passive motion (CPM) machine several times a day.":
Continuous passive motion machines are typically used after knee replacement surgeries, not hip replacement surgeries. Therefore, this statement would not be accurate for a total hip replacement.

(C) "Expect to remain in bed for at least the first 24 hours.":
Early mobilization is crucial after hip replacement surgery to prevent complications such as deep vein thrombosis and to promote recovery. Patients are usually encouraged to get out of bed and start moving with assistance as soon as possible, often within the first 24 hours.

(D) "You will use a special soap to shower with the evening before your surgery.":
Using a special antiseptic soap before surgery is a common preoperative instruction to help reduce the risk of infection. This statement is correct and should be included in the preoperative teaching.