During the immediate postoperative period following thoracic surgery, a nurse medicates a client for pain on a schedule. The rationale for this nursing action is which of the following?
Suppresses the cough reflex
Decreases the level of anxiety
Reduces the respiratory
Facilitates deep breathing
The Correct Answer is D
A. Suppresses the cough reflex: Scheduled pain medication is not intended to suppress coughing, as cough suppression can actually be harmful after thoracic surgery. Clients need to maintain an effective cough to clear secretions and prevent atelectasis or pneumonia. Suppressing this reflex could increase the risk of postoperative respiratory complications.
B. Decreases the level of anxiety: Although adequate pain control can help reduce anxiety, this is not the primary goal in the immediate postoperative period following thoracic surgery. Anxiety relief is a secondary benefit, but it does not directly address the major respiratory risks associated with this type of surgery.
C. Reduces the respiratory rate: Reducing the respiratory rate is not desirable in a postoperative thoracic surgery client. Opioids can depress respirations, which can compromise oxygenation and ventilation. A lower respiratory rate increases the risk of CO₂ retention and postoperative complications.
D. Facilitates deep breathing: Providing pain medication on a schedule ensures that the client can breathe deeply and participate in necessary pulmonary hygiene measures. Thoracic surgery causes significant incisional pain that limits chest expansion, making deep breathing difficult without adequate analgesia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Providing a verbal report of the client's status to a paramedic performing the transfer: Sharing relevant health information with personnel directly involved in the client’s care is appropriate and necessary for continuity of care. This does not constitute a breach of confidentiality because it is directly related to the client’s treatment and transfer.
B. Faxing the client's medical records to the long-term care facility: Sending medical records to the receiving facility ensures that the client’s care can continue without interruption. As long as the transmission is secure and the information is limited to what is necessary, this is an appropriate and legally permissible action.
C. Discussing the client's reaction to the transfer with another staff nurse: Sharing personal information about the client’s emotional response outside of a care-related context is not necessary for treatment or transfer and constitutes a breach of confidentiality. Such discussions should be avoided to protect the client’s privacy.
D. Leaving a phone message for the provider regarding the status of the client's transfer: Communicating with the provider about the client’s care is appropriate. Leaving a message regarding transfer status is relevant to the client’s treatment and does not violate confidentiality, provided the information is limited to necessary clinical details.
Correct Answer is B
Explanation
A. INR 1.1 (0.8 to 1.1): A normal INR indicates proper clotting function and does not increase risk for delayed wound healing. Coagulation status is adequate to support post-surgical recovery.
B. Hyperemesis: Persistent vomiting can lead to fluid and electrolyte imbalances, malnutrition, and protein depletion, all of which impair wound healing. Adequate nutrition is critical for collagen synthesis and tissue repair after surgery.
C. HbA1c 5.6% (4 to 5.9%): A normal HbA1c indicates good blood glucose control, which supports wound healing. Elevated blood glucose can impair healing, but this client’s level is within normal limits.
D. Uncontrolled pain: While uncontrolled pain can affect mobility and stress responses, it does not directly impair the physiological processes of wound healing. Pain management is important but less directly linked to delayed tissue repair than nutritional deficits.
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