The nurse monitors a patient after chest tube placement for a ...

[vicotolentino]

The nurse monitors a patient after chest tube placement for a hemopneumothorax. The nurse is most concerned if which assessment finding is observed?
 
  a. A large air leak in the water-seal chamber
  b. 400 mL of blood in the collection chamber
  c. Complaint of pain with each deep inspiration
  d. Subcutaneous emphysema at the insertion site

Question 2

A patient with newly diagnosed lung cancer tells the nurse, I don't think I'm going to live to see my next birthday. Which response by the nurse is best?
 
  a. Would you like to talk to the hospital chaplain about your feelings?
  b. Can you tell me what it is that makes you think you will die so soon?
  c. Are you afraid that the treatment for your cancer will not be effective?
  d. Do you think that taking an antidepressant medication would be helpful?

[dpost18]

Answer to Question 1

ANS: B
The large amount of blood may indicate that the patient is in danger of developing hypovolemic shock. An air leak would be expected immediately after chest tube placement for a pneumothorax. Initially, brisk bubbling of air occurs in this chamber when a pneumothorax is evacuated. The pain should be treated but is not as urgent a concern as the possibility of continued hemorrhage. Subcutaneous emphysema should be monitored but is not unusual in a patient with pneumothorax. A small amount of subcutaneous air is harmless and will be reabsorbed.

Answer to Question 2

ANS: B
The nurse's initial response should be to collect more assessment data about the patient's statement. The answer beginning Can you tell me what it is is the most open-ended question and will offer the best opportunity for obtaining more data. The answer beginning, Are you afraid implies that the patient thinks that the cancer will be immediately fatal, although the patient's statement may not be related to the cancer diagnosis. The remaining two answers offer interventions that may be helpful to the patient, but more assessment is needed to determine whether these interventions are appropriate.

[vicotolentino]

TYSM

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