A nurse is collecting data from a child who has pertussis. Which of the following manifestations should the nurse expect?

Chest tube management is essential in clients with conditions such as pneumothorax to allow removal of air and re-expansion of the lung. Proper functioning of the drainage system depends on maintaining a closed system and ensuring gravity-assisted drainage. Nursing care focuses on preventing complications such as tension pneumothorax, infection, and impaired drainage. Positioning of the drainage system relative to the client is a key safety consideration.

Rationale:
A. Emptying the collection chamber every 8 hours is not routinely required and should be done only when the chamber is full or per facility protocol. The drainage system is designed to collect fluid safely without frequent emptying. Unnecessary handling increases the risk of contamination and disruption of the closed system.

B. Clamping the chest tube every 4 hours is incorrect because routine clamping can prevent air from escaping the pleural space and may lead to a tension pneumothorax. Clamping is generally avoided unless specifically prescribed for brief diagnostic or procedural purposes. Continuous patency is essential for effective treatment of conditions like Chest tube insertion.

C. Placing the client in a supine position is not recommended because it does not facilitate optimal lung expansion or drainage. Clients with chest tubes are typically positioned in semi-Fowler’s or upright positions to promote lung re-expansion and improve ventilation. Supine positioning may worsen respiratory effort.

D. Ensuring the device is kept below the level of the client’s chest is correct because it allows gravity to facilitate drainage and prevents backflow of air or fluid into the pleural space. This maintains the integrity of the closed drainage system and supports effective removal of air in a pneumothorax. Proper positioning is critical for safe and effective chest tube function.

Home safety management after a cerebrovascular accident (Stroke) focuses on reducing fall risk, improving mobility safety, and preventing environmental hazards related to impaired balance, weakness, and sensory deficits. Clients post-stroke often experience hemiparesis, visual field deficits, and impaired judgment, all of which increase the risk of injury in the home setting. Nursing interventions prioritize elimination of hazards and optimization of environmental visibility and accessibility.

Rationale:
A. Running extension cords under throw rugs is unsafe because it increases the risk of tripping and electrical hazards. Throw rugs can also shift underfoot, especially in clients with hemiparesis or impaired balance. This combination significantly elevates fall risk and should be avoided in post-stroke home safety planning.

B. Replacing burned-out light bulbs is essential because adequate lighting reduces fall risk and improves environmental awareness. Stroke clients may have visual-spatial deficits or neglect, making well-lit environments critical for safe mobility. Proper lighting helps the client identify obstacles and navigate the home more safely.

C. Soft-soled slippers may actually increase the risk of slipping if they lack adequate tread or support. Post-stroke clients require stable, non-skid footwear that provides firm heel support and traction. Footwear selection should prioritize safety and stability rather than softness.

D. Setting the water heater to 54.4°C (130°F) is too high and increases the risk of burns, especially in clients with sensory deficits following stroke. Safer recommendations typically involve lower temperatures to prevent scald injuries. This setting does not align with safe home modification practices for neurologically impaired clients.