Author Question: A client is in the emergency department with an esophageal trauma. The nurse palpates subcutaneous ... (Read 34 times)

xroflmao · **on:** Jun 25, 2018

A client is in the emergency department with an esophageal trauma. The nurse palpates subcutaneous emphysema in the mediastinal area and up into the lower part of the client's neck. What action by the nurse takes priority?

a. Assess the client's oxygenation.
b. Facilitate a STAT chest x-ray.
c. Prepare for immediate surgery.
d. Start two large-bore IVs.

Question 2

A client is scheduled for a traditional esophagogastrostomy . All preoperative teaching has been completed and the client and family show good understanding. What action by the nurse is best?

a. Arrange an intensive care unit tour.
b. Assess the client's psychosocial status.
c. Document the teaching and response.
d. Have the client begin nutritional supplements.

jharrington11 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: A
The priorities of care are airway, breathing, and circulation. The priority option is to assess oxygenation. This occurs before diagnostic or therapeutic procedures. The client needs two large-bore IVs as a trauma client, but oxygenation comes first.

Answer to Question 2

ANS: B
Clients facing this long, difficult procedure are often anxious and fearful. The nurse should now assess the client's psychosocial status and provide the care and teaching required based on this assessment. An intensive care unit tour may help decrease stress but is too limited in scope to be the best response. Documentation should be thorough, but the nurse needs to do more than document. The client should begin nutritional supplements prior to the operation, but again this response is too limited in scope.