The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

Sitting upright with elbows on an over-bed table and feet supported

Sitting in bed with knees slightly flex and feet flexed

Lying flat in the fetal position on the unaffected side

Lying flat on the unaffected side with knees slightly flexed

Answer and Explanation

The Correct Answer is A

A. The optimal position for a thoracentesis is sitting upright with the patient leaning forward slightly, with elbows resting on an over-bed table to help expose the pleural space for access. This position allows gravity to pull the lungs downward and facilitates easier access to the pleural cavity.
B. Sitting in bed with knees slightly flexed and feet flexed is not the best position for thoracentesis. This position might limit the ability to properly expose the thoracic cavity for the procedure.
C. Lying flat in the fetal position on the unaffected side would not allow for effective drainage or access to the pleural space and is not ideal for thoracentesis.
D. Lying flat on the unaffected side with knees slightly flexed is not ideal because it does not provide optimal positioning for the procedure. The upright position is preferred for thoracentesis to facilitate easy access to the pleural space.

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Correct Answer is A

Explanation

A. Placing the patient in a lateral recovery position is the best immediate action. This position helps facilitate drainage of secretions, especially after a laryngectomy, which can reduce the risk of aspiration and airway obstruction. The blood-tinged mucus may be due to recent surgery and should be monitored for changes.
B. The activation of the rapid-response team may be necessary if the patient’s condition worsens or becomes critical, but there is no indication of an acute life-threatening event based on the blood-tinged mucus alone.
C. Monitoring the oxygen saturation and respiratory rate is important, but it is a secondary concern compared to providing a position that promotes drainage and prevents aspiration.
D. Increasing humidification of the oxygen may help keep the airway moist, but the immediate priority should be ensuring proper positioning to allow secretion drainage and prevent aspiration.

A. Wheezes B. Stridor C. Crackles D. Rhonchi

Correct Answer is A

Explanation

A. Wheezes are continuous, high-pitched musical sounds produced by the narrowing of airways, commonly heard in conditions like asthma. They occur mainly during exhalation and are indicative of airflow obstruction.
B. Stridor is a high-pitched, harsh sound that occurs during inspiration, often associated with an upper airway obstruction, such as laryngospasm or a foreign body.
C. Crackles are fine, crackling sounds heard during inspiration, typically due to fluid accumulation in the lungs (e.g., in pneumonia or heart failure).
D. Rhonchi are low-pitched, snoring sounds caused by the obstruction or narrowing of larger airways, often heard in conditions like chronic bronchitis, but they are not high-pitched like wheezes.

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The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

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