A nurse is planning postoperative care for a client who is scheduled for a thoracotomy with chest tube placement. Which of the following pieces of equipment should the nurse plan to have at the client's bedside?

Wire cutters

Montgomery straps

Tracheostomy tray

Padded clamp

Answer and Explanation

The Correct Answer is D

A. Wire cutters:
Wire cutters are typically not necessary for postoperative care following a thoracotomy with chest tube placement. They are more commonly used in situations such as removing orthopedic hardware or cutting wires in emergency situations. Therefore, wire cutters are not essential equipment for this particular procedure.

B. Montgomery straps:
Montgomery straps are adhesive strips used to secure dressings or bandages without the need for tape. While they can be useful in some postoperative situations, they are not specifically required for a thoracotomy with chest tube placement.

C. Tracheostomy tray:

A tracheostomy tray contains equipment necessary for performing tracheostomy care, such as sterile gloves, tracheostomy tubes, and suctioning equipment. It is not directly related to thoracotomy or chest tube care post op.

D. Padded clamp:
A padded clamp, or chest tube holder, is a device used to secure chest tubes in place and prevent them from being accidentally dislodged. It is an essential piece of equipment for postoperative care following a thoracotomy with chest tube placement, as it helps maintain the integrity of the chest tubes and prevents complications such as air leaks or pneumothorax.

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Correct Answer is B

Explanation

A. The client's heart rate increases by 10/min: An increase in heart rate upon changing positions may occur as a compensatory mechanism to maintain blood pressure, but it is not indicative of orthostatic hypotension. Orthostatic hypotension is characterized by a decrease in blood pressure upon assuming an upright position.
B. The client's systolic blood pressure decreases by 25 mm Hg: Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a decrease in diastolic blood pressure of 10 mm Hg or more, within 3 minutes of standing up from a supine position. Therefore, a decrease in systolic blood pressure by 25 mm Hg upon changing positions is consistent with orthostatic hypotension.
C. The client's diastolic blood pressure increases by 10 mm Hg: Orthostatic hypotension typically involves a decrease in both systolic and diastolic blood pressure upon assuming an upright position. An increase in diastolic blood pressure is not consistent with orthostatic hypotension.
D. The client reports heart palpitations: Heart palpitations may occur due to various reasons, such as anxiety or cardiac arrhythmias, but they are not specific to orthostatic hypotension. While orthostatic hypotension may cause symptoms like dizziness or lightheadedness, heart palpitations are not typically associated with this condition.

A. Tell the client to gently stroke their lower abdomen. B. Turn on the faucets in the client's sink. C. Pour cool water over the client's perineum. D. Instruct the client to lean slightly backward.

Correct Answer is A

Explanation

A. Tell the client to gently stroke their lower abdomen: Gentle stroking of the lower abdomen can stimulate the bladder's reflex arc, potentially facilitating urination. This action may help the client relax and initiate the voiding reflex, making it easier for them to urinate into the bedpan.
B. Turn on the faucets in the client's sink: This technique, known as "running water" or "audio voiding," can sometimes stimulate the urge to urinate. However, it may not be feasible or practical for all clients, especially those on bed rest who may not have access to a sink or bathroom.
C. Pour cool water over the client's perineum: Cool water application to the perineum may cause discomfort and is not typically used to stimulate urination. Additionally, it may not effectively address the client's difficulty with urinating into a bedpan.
D. Instruct the client to lean slightly backward: Leaning backward may not be helpful and could potentially make it more challenging for the client to urinate into the bedpan. It's essential for the client to be in a comfortable position that facilitates relaxation and bladder emptying.

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A nurse is planning postoperative care for a client who is scheduled for a thoracotomy with chest tube placement. Which of the following pieces of equipment 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 B

Explanation

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Correct Answer is A

Explanation

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