A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

Choice A Reason:

Suctioning secretions from the endotracheal tube is a common intervention for high-pressure alarms, which indicate an obstruction in the airway. However, a low-pressure alarm typically signals a disconnection or leak in the ventilator system, not an obstruction.

Choice B Reason:

Checking the ventilator tubing connections is the appropriate response to a low-pressure alarm. This alarm usually indicates a disconnection or leak in the ventilator circuit, which can compromise the delivery of adequate ventilation to the patient. Ensuring all connections are secure is the first step in troubleshooting this issue.

Choice C Reason:

Administering intravenous sedation and analgesia is not directly related to addressing a low-pressure ventilator alarm. While sedation may be necessary for patient comfort and to prevent agitation, it does not resolve the underlying issue of a disconnection or leak in the ventilator system.

Choice D Reason:

Reassuring the client and instructing them not to bite on the tube is more relevant to high-pressure alarms, where patient actions such as biting the tube can cause increased airway resistance. It does not address the cause of a low-pressure alarm, which is typically due to a disconnection or leak.

Choice A Reason

“Avoid strenuous activities for 1 week following the procedure.” This statement is partially correct. While it is advisable to avoid strenuous activities, the exact duration can vary. Typically, patients are advised to avoid heavy lifting and vigorous activities for a few days to a week, depending on their recovery.

Choice B Reason

“You will lie on your back during the procedure.” This statement is incorrect. For a bone marrow biopsy from the iliac crest, the patient usually lies on their side or stomach to allow access to the hip bone. Lying on the back would not provide the necessary access for the procedure.

Choice C Reason

“You will receive general anesthesia for the procedure.” This statement is incorrect. Bone marrow biopsies are usually performed under local anesthesia to numb the area. General anesthesia is not typically required. The patient may also receive a mild sedative to help them relax.

Choice D Reason

“Take acetaminophen as prescribed for pain relief after the procedure.” This is the correct statement. Acetaminophen is commonly recommended for pain relief after a bone marrow biopsy because it is effective and has fewer side effects compared to other pain medications like NSAIDs, which can increase the risk of bleeding.