A client with diabetes is experiencing frequent episodes of hypoglycemia. The nurse should recommend which of the following strategies to prevent hypoglycemic episodes?

Choice A rationale:

The nurse should obtain a physician's order and informed consent from the patient before removing the chest tube. Rationale: Chest tube removal is a medical procedure that requires a physician's order, and obtaining informed consent ensures that the patient is aware of the procedure and its potential risks.

Choice B rationale:

Instructing the patient to exhale forcefully during the removal is not necessary and may even be harmful. Rationale: The Valsalva maneuver, which involves forceful exhalation, can increase intrathoracic pressure and may lead to complications like pneumothorax during chest tube removal. Therefore, this action should be avoided.

Choice C rationale:

Monitoring the patient's respiratory status and vital signs after the removal is essential. Rationale: After chest tube removal, it is crucial to monitor the patient for signs of respiratory distress, such as shortness of breath or decreased oxygen saturation, and vital signs to detect any complications promptly.

Choice D rationale:

Applying an occlusive dressing with petroleum gauze over the wound site after removal is not the standard practice. Rationale: After chest tube removal, the wound site is typically left open to allow for the drainage of any residual air or fluid. Applying an occlusive dressing can trap air or fluid, leading to complications.

Choice E rationale:

Preparing sterile supplies such as a suture removal kit before the procedure is not necessary for chest tube removal. Rationale: Chest tube removal does not require suture removal or sterile supplies. It is a relatively simple procedure that involves removing the chest tube after ensuring proper lung re-expansion and securing the wound with an appropriate dressing.

Choice A rationale:

Applying a pressure dressing to the wound site is not the priority intervention for a chest tube with signs of infection. The primary concern is to address the infection and prevent its spread.

Choice B rationale:

The nurse should prioritize obtaining cultures from the chest tube site to identify the causative organism responsible for the infection. This information will guide the selection of appropriate antibiotics to treat the infection effectively.

Choice C rationale:

Administering oxygen to improve ventilation may be beneficial for some patients, but it does not address the underlying infection. Oxygen therapy can support respiratory function but is not the priority intervention in this situation.

Choice D rationale:

Monitoring vital signs and oxygen saturation is essential but does not address the infection directly. Vital sign monitoring is ongoing, while obtaining cultures is a specific intervention targeted at the suspected infection.