A nurse is preparing to administer 40 mg of furosemide IV. Available is furosemide 10 mg/mL. How many mL should the nurse administer per dose?

The correct answers are:

Condition:

• a. Pneumothorax
  (After a thoracotomy and chest tube insertion, pneumothorax is a potential complication as air can accumulate in the pleural space, compromising lung expansion.)

Actions:

• b. Administer oxygen as prescribed.
  (To ensure adequate oxygenation while resolving the pneumothorax)
• b. Ensure the chest tube is functioning properly.
  (Ensuring the chest tube is removing air from the pleural space to restore lung expansion)

Parameters to Monitor:

• c. Respiratory rate and effort.
  (To assess the client's respiratory status and detect any changes indicating distress or worsening pneumothorax)
• c. Oxygen saturation levels.
  (To continuously assess oxygenation and detect any hypoxia)

Rationale:

A pneumothorax is more likely post-thoracotomy, especially with a chest tube insertion, as air is a primary concern in the pleural space. Monitoring respiratory parameters like oxygen saturation and respiratory effort helps evaluate the client's respiratory function and chest tube efficacy.

Choice A reason: Perform a Blind Finger Sweep

Performing a blind finger sweep is not recommended because it can push the foreign object further into the airway, making the obstruction worse. This method is only advised if the object is clearly visible and can be safely removed without causing further harm.

Choice B reason: Turn the Client to the Side

Turning the client to the side can be helpful in certain situations, such as when the client is unconscious or at risk of vomiting. However, in the case of a conscious client with a foreign body airway obstruction, this action does not directly address the obstruction and is not the first priority.

Choice C reason: Insert an Oral Airway

Inserting an oral airway is typically used to maintain an open airway in an unconscious patient who cannot maintain their own airway. For a conscious client with a foreign body obstruction, this action is not appropriate and could cause further complications.

Choice D reason: Administer the Abdominal Thrust Maneuver

Administering the abdominal thrust maneuver (also known as the Heimlich maneuver) is the recommended first action for a conscious client with a foreign body airway obstruction. This technique involves standing behind the client, placing a fist just above their navel, and delivering quick, upward thrusts to expel the foreign object. This method is effective in creating an artificial cough that can dislodge the obstruction.