A nurse is assessing a client who has recently started supplemental oxygen therapy. Which signs indicate that the therapy is ineffective? (Select all that apply)

Choice A reason: Measuring arm circumference quantifies swelling, a sign of complications like thrombosis or infection. Comparing both arms establishes a baseline, aiding in assessing edema severity. This objective data guides interventions, prioritizing assessment before invasive actions, ensuring accurate diagnosis and management of PICC-related issues like venous thrombosis.

Choice B reason: Notifying the provider is important but not the first step. Measuring arm circumference provides objective data to report accurately. Swelling may indicate thrombosis or infection, but without measurements, premature notification lacks specificity, potentially delaying interventions based on clinical findings and diagnostic confirmation.

Choice C reason: Removing the PICC line is premature without confirming the cause of swelling. Thrombosis, infection, or mechanical issues could cause swelling, but removal risks complications like bleeding. Assessment, like measuring arm circumference, is needed first to determine if removal or other interventions are warranted.

Choice D reason: Applying a cold pack may reduce swelling but does not address underlying causes like thrombosis or infection. Without assessing the extent and cause of swelling, this intervention is inappropriate as a first step. Objective data collection, like measuring arm circumference, guides effective treatment and prevents complications.

Choice A reason: Explaining that all people feel anxious minimizes the client’s concerns, potentially dismissing valid fears. This does not address specific anxieties, which may escalate, impacting recovery or consent. Encouraging expression fosters therapeutic communication, making this a less effective approach for addressing preoperative anxiety.

Choice B reason: Suggesting the client talk to the provider may clarify surgical concerns but delays immediate emotional support. Nurses can address anxiety through therapeutic communication, making it more appropriate to encourage expression of feelings rather than deferring to the provider initially for emotional support.

Choice C reason: Distracting the client by changing the subject avoids addressing anxiety, which may worsen emotional distress and affect surgical outcomes. Unresolved anxiety increases stress hormones, impacting recovery, making this ineffective compared to encouraging open expression of the client’s concerns.

Choice D reason: Encouraging the client to express feelings addresses preoperative anxiety, reducing stress hormones like cortisol that impair healing. Therapeutic communication validates fears, promotes coping, and enhances trust, making this the most effective nursing action to support emotional and physical preparation for surgery.