A nurse is caring for a client who has a chest tube in place to a closed chest drainage system. Which of the following findings should indicate to the nurse that the client’s lung has expanded?

The correct answer is: d. On the nonoperative side

Choice A: Prone

Reason: Placing a patient in the prone position (lying face down) after a pneumonectomy is generally not recommended. This position can compromise respiratory function by restricting chest expansion and increasing the risk of respiratory complications. Additionally, it can place undue pressure on the surgical site, potentially leading to complications such as impaired wound healing or increased pain.

Choice B: Semi-Fowler’s

Reason: The Semi-Fowler’s position (head of the bed elevated to 30-45 degrees) is often used to promote lung expansion and reduce the risk of aspiration. While it can be beneficial for general postoperative care, it is not the optimal position for a patient who has undergone a pneumonectomy. This position does not specifically address the need to prevent fluid accumulation in the remaining lung.

Choice C: Sims

Reason: The Sims position (lying on the side with one leg bent) is typically used for procedures such as enemas or to facilitate drainage of oral secretions. It is not suitable for a postoperative pneumonectomy patient because it does not provide the necessary support to the remaining lung and can increase the risk of fluid shifting to the nonoperative side.

Choice D: On the nonoperative side

Reason: Placing the patient on the nonoperative side is the correct position. This position helps to prevent fluid from accumulating in the remaining lung and reduces the risk of complications such as mediastinal shift or respiratory distress. By positioning the patient on the nonoperative side, gravity helps to keep the remaining lung expanded and functional.

Choice A reason: The client exhales as the medication is released from the inhaler. This action is incorrect because it wastes the medication and reduces its effectiveness. The client should exhale before using the inhaler, not during.

Choice B reason: The client waits 10 minutes between inhalations. This action is incorrect because it delays the relief of the asthma symptoms. The client should wait only one minute between inhalations, unless instructed otherwise by the doctor.

Choice C reason: The client holds his breath for 10 seconds after inhaling the medication. This action is correct because it allows the medication to reach the lungs and bronchial tubes more effectively and reduce the inflammation and constriction of the airways.

Choice D reason: The client takes a quick inhalation while releasing the medication from the inhaler. This action is incorrect because it can cause the medication to hit the back of the throat and not reach the lungs. The client should take a slow and deep inhalation while using the inhaler.