What Do You Know About Thoracentesis? Trivia Quiz

1. A client has just returned to a nursing unit after an above-knee amputation of the right leg. The nurse should place the client in which position?

Prone.

Reverse Trendelenburg’s.

Supine, with the residual limb flat on the bed.

Supine, with the residual limb supported with pillows.

The residual limb is usually supported on pillows for the first 24 hours following surgery to promote venous return and decrease edema. After the first 24 hours, the residual limb usually is placed flat on the bed to reduce hip contracture. Edema also is controlled by limb-wrapping techniques. In addition, it is important to check health care provider prescriptions regarding positioning following amputation.

Explanation

The residual limb is usually supported on pillows for the first 24 hours following surgery to promote venous return and decrease edema. After the first 24 hours, the residual limb usually is placed flat on the bed to reduce hip contracture. Edema also is controlled by limb-wrapping techniques. In addition, it is important to check health care provider prescriptions regarding positioning following amputation.

2. The nurse is caring for a client who is 1-day postoperative for a total hip replacement. Which is the best position in which the nurse should place the client?

Side-lying on the operative side.

On the nonoperative side with the legs abducted.

Side-lying with the affected leg internally rotated.

Side-lying with the affected leg externally rotated.

Positioning following a total hip replacement depends on the surgical techniques used, the method of implantation, the prosthesis, and the health care provider’s (HCP’s) preference. Abduction is maintained when the client is in a supine position or positioned on the nonoperative side. Internal and external rotation, adduction, or side-lying on the operative side (unless specifically prescribed by the HCP) is avoided to prevent displacement of the prosthesis.

Explanation

Positioning following a total hip replacement depends on the surgical techniques used, the method of implantation, the prosthesis, and the health care provider’s (HCP’s) preference. Abduction is maintained when the client is in a supine position or positioned on the nonoperative side. Internal and external rotation, adduction, or side-lying on the operative side (unless specifically prescribed by the HCP) is avoided to prevent displacement of the prosthesis.

3. The nurse is caring for a client immediately after the removal of the endotracheal tube. The nurse should report which sign immediately if experienced by the client?

Stridor

Occasional pink-tinged sputum

Respiratory rate of 24 breaths/minute.

A few basilar lung crackles on the right.

Following removal of the endotracheal tube, the nurse monitors the client for respiratory distress. The nurse reports stridor to the health care provider (HCP) immediately. This is a high-pitched, coarse sound that is heard with the stethoscope over the trachea. Stridor indicates airway edema and places the client at risk for airway obstruction. Although the findings identified in the remaining options require monitoring, they do not require immediate notification of the HCP.

Explanation

Following removal of the endotracheal tube, the nurse monitors the client for respiratory distress. The nurse reports stridor to the health care provider (HCP) immediately. This is a high-pitched, coarse sound that is heard with the stethoscope over the trachea. Stridor indicates airway edema and places the client at risk for airway obstruction. Although the findings identified in the remaining options require monitoring, they do not require immediate notification of the HCP.

4. A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the procedure?

Lying in bed on the affected side.

Lying in bed on the unaffected side.

Sims’ position with the head of the bed flat.

Prone with the head turned to the side and supported by a pillow .

To facilitate removal of fluid from the chest, the client is positioned sitting at the edge of the bed leaning over the bedside table, with the feet supported on a stool; or lying in bed on the unaffected side with the head of the bed elevated 30 to 45 degrees. The prone and Sims’ positions are inappropriate positions for this procedure.

Explanation

To facilitate removal of fluid from the chest, the client is positioned sitting at the edge of the bed leaning over the bedside table, with the feet supported on a stool; or lying in bed on the unaffected side with the head of the bed elevated 30 to 45 degrees. The prone and Sims’ positions are inappropriate positions for this procedure.

5. While changing the tapes on a newly inserted tracheostomy tube, the client coughs and the tube is dislodged. Which is the initial nursing action?

Call the health care provider to reinsert the tube.

Grasp the retention sutures to spread the opening.

Call the respiratory therapy department to reinsert the tracheotomy.

Cover the tracheostomy site with a sterile dressing to prevent infection.

If the tube is dislodged accidentally, the initial nursing action is to grasp the retention sutures and spread the opening. If agency policy permits, the nurse then attempts to replace the tube immediately. Calling ancillary services or the health care provider will delay treatment in this emergency situation. Covering the tracheostomy site will block the airway.

Explanation

If the tube is dislodged accidentally, the initial nursing action is to grasp the retention sutures and spread the opening. If agency policy permits, the nurse then attempts to replace the tube immediately. Calling ancillary services or the health care provider will delay treatment in this emergency situation. Covering the tracheostomy site will block the airway.