A nurse is planning care for a client who is to receive a neuromuscular blocking agent. Which of the following items should the nurse plan to have at the client's bedside?

Bag-valve-mask device

Client's personal phone

Urinary catheter insertion tray

Central venous catheterization tray

Answer and Explanation

The Correct Answer is A

A. Bag-valve-mask device should always be at the bedside when administering a neuromuscular blocking agent because these medications cause paralysis of respiratory muscles, including the diaphragm. The client will require manual ventilation support if mechanical ventilation fails or is delayed to ensure adequate oxygenation.
B. Client's personal phone is not a priority item for immediate bedside safety. Although maintaining communication with loved ones is important for emotional well-being, the critical concern with neuromuscular blockade is airway management and respiratory support.
C. Urinary catheter insertion tray may eventually be necessary if the client is immobilized for a prolonged period, but it is not an immediate requirement when administering a paralytic agent. The priority remains ensuring airway patency and respiratory support.
D. Central venous catheterization tray is not required solely for administering a neuromuscular blocking agent. While some critically ill patients need central access, peripheral intravenous access is often sufficient for delivering the medication itself.

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Correct Answer is D

Explanation

A. Night sweats can occur with infections such as tuberculosis and occasionally with severe bacterial infections, but they are not the most specific or early sign of pneumonia or hypoxia in an older adult. In elderly clients, more subtle or atypical signs such as mental status changes are often more indicative of underlying respiratory compromise.
B. Normothermia, or having a normal body temperature, is common in older adults even during infections. Older adults may present with a blunted febrile response to infection, meaning they might not have a high fever. However, normothermia alone does not directly signal pneumonia or hypoxia and could lead to underrecognition of infection severity if relied on solely.
C. Narrowed pulse pressure, defined as a small difference between systolic and diastolic blood pressures, can indicate cardiac issues such as heart failure or shock but is not a hallmark of pneumonia or hypoxia. While hypoxia can eventually impair cardiac function, narrowed pulse pressure is not the most reliable or early respiratory indicator.
D. Confusion is a common and often early sign of pneumonia and hypoxia in older adults. Due to decreased cerebral oxygenation and the blunted inflammatory response of aging, older adults frequently present with delirium or acute confusion when seriously ill, even before respiratory symptoms become prominent.

A. Constant bubbling in the wet suction-control chamber B. Occasional bubbling in the water-seal chamber C. Continuous bubbling in the water-seal chamber D. Fluctuations in the fluid level in the water-seal chamber

Correct Answer is C

Explanation

A. Constant bubbling in the wet suction-control chamber is expected when the suction is set properly. This chamber regulates the amount of negative pressure applied, and continuous bubbling here indicates that suction is actively being delivered without necessarily implying a complication.
B. Occasional bubbling in the water-seal chamber can be normal, particularly when the client coughs, exhales, or changes positions. Brief bubbling represents air escaping from the pleural space during lung healing, which is not immediately concerning if intermittent.
C. Continuous bubbling in the water-seal chamber indicates an air leak in the chest tube system or within the client's pleural space. An ongoing air leak prevents full lung re-expansion and requires immediate assessment and intervention to locate and correct the source.
D. Fluctuations in the fluid level in the water-seal chamber, known as tidaling, are expected with normal respiration. The fluid rises with inspiration and falls with expiration, and its presence is a sign that the system is patent and the lung has not yet fully re-expanded.

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A nurse is planning care for a client who is to receive a neuromuscular blocking agent. Which of the following items should the nurse plan to have at the client's bedside?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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