Which of the following nursing diagnoses (nursing problem) would be of highest priority for the patient hospitalized for a bone marrow transplant to treat relapse of acute myelocytic leukemia?

The correct answer is Choice A

Choice A rationale: Movement of the trachea toward the unaffected side indicates a possible tension pneumothorax, which is a life-threatening condition. This shift occurs due to the increased pressure on the affected side, pushing the trachea away. Immediate intervention is required.

Choice B rationale: Crepitus, or subcutaneous emphysema, can be a common finding around the chest tube insertion site. It indicates air leakage into the subcutaneous tissue but does not necessarily require immediate notification to the provider unless it is extensive or worsening.

Choice C rationale: Bubbling of the water in the water seal chamber with exhalation is expected and indicates that the chest tube is functioning properly by allowing air to escape from the pleural space. This is a normal finding in pneumothorax management.

Choice D rationale: The visibility of eyelets on the chest tube indicates that the tube is in the correct position within the pleural space. If the eyelets are not visible, it means the tube is not functioning correctly, but this is not as urgent as a tracheal shift.

Choice A reason: Stroke Volume refers to the amount of blood pumped by the left ventricle of the heart in one contraction, not to the regulation of fluid volume and cardiac output.

Choice B reason: Renin-Angiotensin-Aldosterone-System (RAAS) is responsible for vasoconstriction, sodium retention, and water reabsorption, which helps to increase circulating fluid volume and cardiac output.

Choice C reason: Brain and Atrial natriuretic peptides (BNP & ANP) actually work to decrease blood volume and pressure, not increase them.

Choice D reason: Erythropoietin primarily stimulates red blood cell production and does not directly affect fluid volume or cardiac output.