A nurse is caring for a client who is 12 hours postoperative and has a chest tube to a disposable water-seal drainage system with suction. The nurse should intervene for which of the following observations?

Choice A rationale
While chest pain can occur after pacemaker insertion, it is not the primary concern immediately following the procedure. The nurse should monitor for more critical complications such as arrhythmias, which can indicate pacemaker malfunction or lead displacement.
Choice B rationale
Infection is a potential complication after pacemaker insertion, but it typically develops over a longer period. Immediate monitoring should focus on acute complications such as arrhythmias.
Choice C rationale
Bleeding is a concern after any surgical procedure, including pacemaker insertion. However, the primary immediate concern is monitoring for arrhythmias, which can indicate issues with the pacemaker’s function.
Choice D rationale
Arrhythmias are the primary concern immediately following pacemaker insertion. The nurse should monitor the client for any irregular heart rhythms, which can indicate pacemaker malfunction or lead displacement. Prompt identification and management of arrhythmias are crucial to ensure the pacemaker is functioning correctly.

Choice A rationale
A room that is within view of the nurses’ station is not suitable for a client with active tuberculosis. This placement does not provide the necessary isolation to prevent the spread of the infection to other patients and staff. Tuberculosis is an airborne disease, and the client needs to be in a room that minimizes the risk of airborne transmission.
Choice B rationale
A room with another nonsurgical client is also inappropriate for a client with active tuberculosis. Placing the client with another patient increases the risk of transmission of the infection. Tuberculosis requires strict airborne precautions, and the client should be in a private room with appropriate ventilation.
Choice C rationale
A room in the ICU is not necessary unless the client requires intensive care for other reasons. The primary concern for a client with active tuberculosis is to prevent the spread of the infection, which can be effectively managed in a regular medical-surgical unit with proper isolation measures.
Choice D rationale
A room with air exhaust directly to the outdoor environment is the correct choice. This type of room, often referred to as a negative pressure room, ensures that air from the room does not flow to other parts of the facility, thereby preventing the spread of infectious airborne particles. This setup is essential for managing clients with active tuberculosis.