Med Surg Exam 3 - Chapter 28

The correct answer is to assess the central line immediately for any obstruction or accidental clamping of tubing. This is the most appropriate action to take when the alarm indicates an obstruction in the intravenous line downstream. By assessing the central line, the nurse can identify and resolve any issues that may be causing the obstruction, such as a kinked or clamped tubing. This will ensure that the continuous epoprostenol infusion can resume without interruption and prevent any potential complications for the patient.

Teaching the patient how to cough effectively to bring secretions to the mouth is an appropriate nursing intervention for a patient with pneumonia and the nursing diagnosis of ineffective airway clearance related to thick secretions and fatigue. This intervention helps the patient to effectively clear the airway by coughing and expectorating the thick secretions. It promotes airway clearance and prevents complications such as respiratory distress and infection.

The patient receiving high-dose corticosteroids and broad-spectrum antibiotics is most susceptible to candidiasis. High-dose corticosteroids can suppress the immune system, making the patient more susceptible to fungal infections such as candidiasis. Broad-spectrum antibiotics can disrupt the normal balance of bacteria in the body, allowing Candida (a type of fungus) to overgrow and cause an infection. Aspergillosis, histoplasmosis, and coccidioidomycosis are all fungal infections, but they are not specifically associated with the use of corticosteroids and antibiotics in the same way that candidiasis is.

The patient with lung cancer needs to receive both the influenza vaccine and pneumococcal vaccines. Administering both vaccines at the same time ensures that the patient receives the necessary immunizations efficiently. By administering the vaccines in different arms, it reduces the risk of any potential adverse reactions or interactions between the vaccines.

The correct answer is "paradoxic chest movement occurs during respiration." Flail chest refers to a condition in which multiple rib fractures result in a segment of the chest wall becoming detached from the rest of the chest wall. This detachment causes paradoxical movement, meaning that the affected segment moves in the opposite direction to the rest of the chest during respiration. This can be observed visually as a noticeable inward movement of the affected segment during inspiration and outward movement during expiration. X-ray findings of multiple rib fractures, tracheal deviation, and decreased movement of the involved chest wall may be present in a trauma patient but are not specific to flail chest.

Guillain-Barre syndrome is a neurological disorder that affects the peripheral nervous system. It is characterized by the immune system attacking the nerves, leading to muscle weakness and paralysis. In the case of respiratory problems, Guillain-Barre syndrome interrupts the transmission of nerves to the respiratory muscles. This interruption prevents the muscles responsible for breathing from receiving the necessary signals, resulting in respiratory difficulties.

Pulmonary fibrosis is a common complication of many types of lung diseases. It refers to the scarring and thickening of the lung tissue, which can lead to a decrease in lung function and difficulty in breathing. This condition can be caused by various factors such as exposure to environmental toxins, certain medications, infections, and autoimmune diseases. Over time, the scar tissue replaces healthy lung tissue, making it harder for the lungs to expand and contract properly. This can result in symptoms such as shortness of breath, coughing, and fatigue. Treatment options for pulmonary fibrosis aim to manage symptoms, slow down the progression of the disease, and improve quality of life.

The nurse should continue to monitor the normal finding of tidaling in the water-seal chamber of the closed chest tube drainage system. Tidaling refers to the fluctuation of the fluid level in the tube, which is a normal occurrence. It indicates that the system is functioning properly and that there is no obstruction or significant air leak. Therefore, there is no need for any intervention such as checking for leaks, adjusting the drainage collector, or clamping the tubing.

The statement "Antibiotics given for a prolonged period are the usual treatment of choice" best describes the treatment of lung abscess. This suggests that the primary approach to managing lung abscess involves administering antibiotics over an extended period. Surgical excision and drainage may be necessary in certain cases, but the usual treatment is focused on prolonged antibiotic therapy. The other options either do not align with standard treatment practices or do not provide a comprehensive treatment approach.

The patient should be taught to take all medications for the full length of time to prevent multidrug-resistant TB. This is important to ensure that the TB infection is fully treated and to prevent the development of drug-resistant strains of the disease. The patient should also be taught to wear a standard isolation mask if leaving the airborne infection isolation room, as this helps to prevent the spread of TB to others. Additionally, the patient should be taught to maintain precautions in the airborne infection isolation room by coughing into a paper tissue, which helps to minimize the spread of infectious droplets.

After a pneumonectomy, range-of-motion exercises on the affected upper extremity should be instituted. This is because the surgery involves the removal of a lung, which can lead to decreased lung capacity and impaired respiratory function. Range-of-motion exercises help to maintain and improve the mobility of the affected arm and shoulder, preventing stiffness and muscle weakness. These exercises also promote circulation and prevent complications such as blood clots. Monitoring chest tube drainage and functioning, positioning the patient on the unaffected side or back, and auscultating for lung sounds on the affected side are important aspects of post-operative care, but they are not specific to a pneumonectomy.

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The correct answer is an abrupt onset of fever and productive cough with rust-colored sputum. Pneumococcal pneumonia is characterized by a sudden onset of high fever and chills. The cough is usually productive and the sputum may be rust-colored due to the presence of blood. Other symptoms may include chest pain, shortness of breath, fatigue, and weakness. Night sweats are not typically associated with pneumococcal pneumonia, and a nonproductive cough or a gradual onset of sore throat and purulent productive cough are not specific to this condition.