A nurse is caring for a client who has kidney cancer and has been told it has metastasized. Which of the following statements should the nurse make when the client asks what metastasis means?

A. Asthma: Although asthma can exacerbate respiratory symptoms, it is not the most common risk factor for emphysema. Emphysema primarily arises due to long-term exposure to irritants, such as tobacco smoke.
B. Smoking tobacco: Smoking is the most significant risk factor for emphysema. It leads to chronic inflammation in the lungs and damages the alveolar walls, resulting in the development of emphysema over time.
C. Pollution: While pollution can contribute to lung damage and respiratory issues, smoking tobacco is by far the most prevalent and direct cause of emphysema.
D. Between 20 to 30 years of age: Emphysema typically develops over many years of exposure to harmful substances like cigarette smoke. Age alone, particularly between 20 to 30 years, is not a primary risk factor for emphysema.

A. Notify the rapid response team due to the client’s clinical signs of a tension pneumothorax: The client presents with acute right-sided chest pain, dyspnea, hypotension, unilateral decreased breath sounds, hyperresonance, and agitation—classic signs of a tension pneumothorax, a life-threatening emergency requiring immediate intervention. Rapid response activation ensures rapid access to advanced airway and chest decompression support.
B. Reassure the client and administer prescribed analgesics for pain relief: The pain is a symptom of a serious underlying condition—possibly a collapsed lung. Administering pain medication could delay life-saving intervention.
C. Encourage the client to take deep breaths and use incentive spirometry: This intervention is appropriate for postoperative atelectasis, but it is contraindicated in tension pneumothorax. Increasing intrathoracic pressure through deep breaths may worsen the pneumothorax.
D. Elevate the head of the bed and increase oxygen to 4 L/min via nasal cannula: While increasing oxygen and elevating the head can help improve oxygenation, they do not treat the underlying cause. These supportive measures may be used after emergency intervention has been initiated.
E. Document the findings and re-evaluate in 15 minutes: Delaying intervention in this situation is unsafe. A tension pneumothorax can rapidly lead to cardiovascular collapse, so waiting even a few minutes may result in deterioration or death.