While assessing a client who is 12 hours postoperative after a ...

[kshipps]

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action should the nurse take first?
 
  a. Assess for drainage from the site.
  b. Cover the insertion site with sterile gauze.
  c. Contact the provider and obtain a suture kit.
  d. Reinsert the tube using sterile technique.

Question 2

A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that he no longer enjoys going out with his friends. How should the nurse respond?
 
  a. There are a variety of support groups for people who have COPD.
  b. I will ask your provider to prescribe you with an antianxiety agent.
  c. Share any thoughts and feelings that cause you to limit social activities.
  d. Friends can be a good support system for clients with chronic disorders.

[jasonq]

Answer to Question 1

ANS: B
Immediately covering the insertion site helps prevent air from entering the pleural space and causing a pneumothorax. The area will not reseal quickly enough to prevent air from entering the chest. The nurse should not leave the client to obtain a suture kit. An occlusive dressing may cause a tension pneumothorax. The site should only be assessed after the insertion site is covered. The provider should be called to reinsert the chest tube or prescribe other treatment options.

Answer to Question 2

ANS: C
Many clients with moderate to severe COPD become socially isolated because they are embarrassed by frequent coughing and mucus production. They also can experience fatigue, which limits their activities. The nurse needs to encourage the client to verbalize thoughts and feelings so that appropriate interventions can be selected. Joining a support group would not decrease feelings of social isolation if the client does not verbalize feelings. Antianxiety agents will not help the client with social isolation. Encouraging a client to participate in activities without verbalizing concerns also would not be an effective strategy for decreasing social isolation.