A nurse is providing care for a client who is scheduled for electroconvulsive therapy. Which of the following conditions should the nurse identify as an increased risk for complications?

Choice A reason: Marking drainage output every 48 hours is too infrequent to accurately assess drainage in a closed wound drainage system. Frequent monitoring (e.g., every shift) is needed to track output, detect complications like excessive bleeding, and ensure system functionality, making this intervention inadequate for assessment.
Choice B reason: Stripping the chest tube vigorously is not recommended, as it can increase intrathoracic pressure, risking tissue damage or bleeding. It does not assess drainage amount but manipulates the tube, potentially causing harm. Assessment requires observing output in the collection chamber, making this action incorrect.
Choice C reason: Maintaining the collection chamber below the client’s chest ensures proper drainage by gravity in a closed wound drainage system, like a chest tube. This position prevents backflow and allows accurate measurement of drainage output in the chamber, essential for assessing fluid loss and detecting complications like hemothorax.
Choice D reason: Adding water to the water seal chamber maintains system function but does not directly assess drainage amount. The water seal prevents air re-entry, not measures output. Assessment involves observing and recording drainage in the collection chamber, making this action irrelevant to the question’s focus.

Choice A reason: Using three-pronged grounded plugs ensures proper grounding, reducing the risk of electrical fires by safely dissipating excess current. This prevents shocks and short circuits, aligning with National Fire Protection Association (NFPA) standards. Grounded plugs are essential for safe appliance use, making this a critical recommendation for fire prevention education.
Choice B reason: Checking for a tingling sensation around a cord is not a reliable or safe method for fire prevention. Tingling may indicate electrical faults, but proactive measures like inspecting cords for fraying or overheating are more effective. This approach is reactive and risky, as it does not prevent fires, making it inappropriate.
Choice C reason: Covering extension cords with a rug traps heat and increases wear, raising the risk of electrical fires. Cords should be exposed to air and placed to avoid damage or tripping hazards. This practice violates safety guidelines, as it conceals potential issues, making it an incorrect recommendation for fire prevention.
Choice D reason: Removing a plug by pulling the cord can damage insulation or wiring, increasing fire risk due to exposed conductors or short circuits. Plugs should be grasped firmly at the base to remove safely. This action is unsafe and contradicts electrical safety standards, making it an incorrect teaching point.