A nurse is caring for a client immediately following endotracheal intubation. The nurse should assess the client for complications by performing which of the following priority action?

A. Culturally incompetent caregivers. When healthcare providers lack cultural awareness, they may struggle to communicate effectively with patients from diverse backgrounds. This can lead to misunderstandings, decreased trust, and reduced adherence to treatment plans. Patients may feel unheard or disrespected if their cultural beliefs and preferences are not considered. Cultural competence training helps bridge communication gaps and improves patient-provider relationships.
B. Proper training in healthcare communication. Training in communication enhances a provider’s ability to listen actively, use clear language, and foster patient-centered interactions. It helps reduce medical errors, improve patient understanding, and enhance trust in healthcare providers. Since communication training strengthens interactions rather than hindering them, it is not considered a barrier. Well-trained providers can adapt their approach to meet the needs of each patient effectively.
C. Implicit bias. Unconscious biases can negatively affect how healthcare providers interact with patients, leading to disparities in care. Providers may unintentionally assume things about a patient based on stereotypes rather than their individual needs. This can cause miscommunication, lack of trust, and reluctance to seek care. Recognizing and addressing implicit bias is crucial for ensuring equitable and effective communication.
D. Excellent health literacy. High health literacy enables patients to understand medical information, follow treatment plans, and communicate effectively with providers. This reduces confusion, enhances decision-making, and improves health outcomes. Since excellent health literacy helps rather than hinders communication, it is not a barrier. Instead, it empowers patients to engage more actively in their care.
E. Lack of diversity. A lack of diversity in healthcare can result in communication barriers, as providers may be less familiar with different cultural perspectives and language needs. This can lead to misunderstandings, decreased patient satisfaction, and reduced quality of care. A diverse healthcare workforce fosters inclusivity, improves provider-patient communication, and promotes better health outcomes. Encouraging diversity ensures a more culturally competent and responsive healthcare system.

A. Encourage the client to take breaks from oxygen use to prevent tolerance. Oxygen therapy does not cause "tolerance," and taking breaks can lead to hypoxemia in COPD clients. Continuous low-flow oxygen is essential to maintaining adequate oxygenation while avoiding hypercapnia. Stopping oxygen therapy intermittently can increase the risk of respiratory distress.
B. Assess cheeks and posterior ears for signs of skin breakdown. While it is important to monitor for pressure injuries from nasal cannula tubing, this is a general nursing consideration for all patients receiving oxygen therapy. It is not the highest priority when managing oxygen therapy in clients with COPD, where maintaining appropriate oxygen levels is critical.
C. Maintain nasal oxygen at a 1 to 2 liter/minute flow rate. Clients with COPD often have chronic CO₂ retention and rely on hypoxic drive for ventilation. Administering high-flow oxygen can suppress their respiratory drive, leading to CO₂ narcosis and respiratory failure. To prevent this, oxygen should be administered at the lowest effective flow rate, typically 1 to 2 L/min via nasal cannula, while closely monitoring oxygen saturation and blood gases.
D. Teach the client how to safely increase oxygen flow when they deem necessary. Allowing a client with COPD to adjust their oxygen flow independently can be dangerous, as excessive oxygen can lead to hypercapnia and respiratory depression. Oxygen adjustments should be made based on clinical assessments and healthcare provider orders.