The nurse is providing care to a client with a suspected pulmonary embolism. Which of the following is not a manifestation of a pulmonary embolism?

A. Immediately notify the provider . A rise in the water seal chamber with inspiration (tidaling) is a normal finding, indicating proper function of the chest drainage system. There is no need for immediate provider notification.
B. Clamp the chest tube near the water seal . Clamping the chest tube can lead to a tension pneumothorax by trapping air inside the pleural space. This action is only done temporarily for specific indications, such as assessing for an air leak or changing the drainage system.
C. Continue to monitor the client . Tidaling (fluctuation of water with inspiration and expiration) is expected in the water seal chamber. The nurse should continue to monitor for any sudden cessation of tidaling (which may indicate obstruction) or continuous bubbling (which may indicate an air leak).
D. Reposition the client toward the left side . Position changes do not affect normal tidaling in a functioning chest tube system. However, frequent repositioning is encouraged to promote lung expansion.

A. Massaging the calves is incorrect. This action can dislodge a deep vein thrombus (DVT), increasing the risk of a pulmonary embolism.
B. Applying elastic compression stockings is correct. These help promote venous return, reducing the risk of blood stasis and clot formation.
C. Performing passive range of motion exercises is correct. These exercises prevent venous stasis, which is a major risk factor for DVT and PE.
D. Assessing legs for redness is correct. Redness, swelling, and warmth can indicate DVT formation, allowing for early intervention before it leads to PE.
E. Placing pillows under the client's knees is incorrect. This can impair circulation and increase the risk of clot formation by promoting venous stasis.