The nurse suspects which cause of increased bubbling in the water seal chamber of a patient's chest drainage unit?

The patient has a pleural friction rub.

The patient has an infection at the drainage site.

The patient has a bronchopleural leak.

The patient has complete lung re-expansion.

Answer and Explanation

The Correct Answer is C

A. A pleural friction rub occurs when the pleural surfaces rub against each other, usually due to inflammation, but it does not directly cause increased bubbling in the water seal chamber of a chest drainage unit.
B. An infection at the drainage site could lead to localized symptoms like redness or discharge, but it does not directly cause increased bubbling in the water seal chamber.
C. A bronchopleural leak is the most likely cause of increased bubbling in the water seal chamber. This occurs when there is an air leak between the lungs and pleural space, causing continuous air to enter the chest drainage system.
D. Complete lung re-expansion would not typically cause bubbling in the water seal chamber. Once the lung is fully re-expanded, bubbling should stop.

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Correct Answer is C

Explanation

A. "It is caused by the lack of production of insulin by the pancreas.": This is incorrect. The lack of insulin production causes diabetes mellitus, not Addison’s disease. Addison’s disease results from insufficient production of adrenal hormones, particularly aldosterone and cortisol.
B. "It is caused by the overproduction of parathormone by the parathyroid gland.": This is incorrect. Parathormone is produced by the parathyroid glands and regulates calcium balance, but overproduction of parathormone leads to conditions such as hyperparathyroidism, not Addison’s disease.
C. "It is caused by the lack of production of aldosterone by the adrenal gland.": This is correct. Addison’s disease, also known as primary adrenal insufficiency, is caused by the inability of the adrenal glands to produce sufficient aldosterone and cortisol, two critical hormones. Aldosterone helps regulate sodium and potassium balance, and cortisol helps the body respond to stress.
D. "It is caused by the overproduction of growth hormone by the pituitary gland.": This is incorrect. Overproduction of growth hormone causes acromegaly or gigantism, not Addison’s disease. Addison’s disease results from adrenal insufficiency, not pituitary gland dysfunction.

A. Elevate the head of the client's bed to 45° during meals. B. Provide the client with oral hygiene. C. Instruct the client to tilt their head back while swallowing. D. Turn on the television for the client during meals.

Correct Answer is A

Explanation

A. Elevate the head of the client's bed to 45° during meals: This is the correct action. Elevating the head during meals helps promote proper swallowing and reduces the risk of aspiration by preventing food or liquid from entering the airway. A semi-upright position is essential for clients at risk of aspiration, particularly those with dementia, who may have impaired swallowing reflexes.
B. Provide the client with oral hygiene: While important for oral health and to reduce bacteria in the mouth, this action does not directly reduce the risk of aspiration during meals. Oral hygiene is beneficial for preventing infections, but it doesn't influence the act of swallowing during eating.
C. Instruct the client to tilt their head back while swallowing: This is incorrect. Tilting the head back can cause difficulty in swallowing and increase the risk of aspiration. The correct technique is to maintain a neutral or slightly forward position of the head to allow food to travel smoothly down the esophagus and prevent it from entering the airway.
D. Turn on the television for the client during meals: This is not recommended as it can distract the client from focusing on eating. Distractions like a television may reduce the client's ability to concentrate on the swallowing process, increasing the risk of aspiration and choking.

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The nurse suspects which cause of increased bubbling in the water seal chamber of a patient's chest drainage unit?

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