A client has a new order to take guaifenesin (Mucinex) every 4 hours as needed. The nurse giving medication instructions to the client tells the client to be sure to:

A. Have the client lean over an over-the-bed table:This position is sometimes used during posterior thoracic examination or for percussing lung fields, but it is not standard for routine chest auscultation. Most chest sounds can be assessed with the client sitting upright or lying down.

B. Use the bell of the stethoscope held lightly against the chest:The bell is best for detecting low-pitched sounds like some heart murmurs, not respiratory sounds. Lung sounds are higher-pitched and require use of the diaphragm for accurate auscultation.

C. Use the diaphragm of the stethoscope held firmly against the chest:This is the correct technique for auscultating lung sounds, which are typically high-pitched. Holding the diaphragm firmly ensures clear transmission of breath sounds such as crackles, wheezes, or rhonchi.

D. Instruct the client to take deep, rapid breaths through their nose:Deep breathing is appropriate during auscultation, but it should be done through the mouth. Breathing through the nose may reduce air entry and obscure abnormal sounds, making it harder to detect lung pathology.

A. Return to the ED immediately for a cough that gets worse at night:While worsening symptoms should be monitored, mild nighttime worsening of croup is common. Immediate return to the ED is not necessary unless there are signs of respiratory distress like stridor at rest, retractions, or cyanosis.

B. Take the child into a steamy hot bathroom for 15 minutes:Exposure to humidified air can help loosen mucus and reduce airway inflammation, easing the barking cough associated with croup. This home remedy is safe and effective for nighttime symptoms in mild cases.

C. Give the child warm liquids to soothe the throat:Infants under 6 months should not be given liquids other than breast milk or formula unless specifically instructed by a provider. Warm liquids also pose a risk of burns or aspiration in young infants.

D. Give the child over-the-counter cough suppressants:OTC cough suppressants are not recommended for children under 6 years old due to lack of proven benefit and risk of side effects. They can suppress the protective cough reflex and should be avoided in infants.