A nurse is providing teaching to a client about manifestations of pulmonary embolism (PE). Which of the following findings should the nurse include in the teaching? (Select All that Apply.)

Chest pain that worsens with deep breathing

Shortness of breath

Facial weakness that worsens at night

Bloody sputum

Difficulty speaking

Answer and Explanation

Correct Answer : A

A. Chest pain that worsens with deep breathing, also known as pleuritic pain, is a hallmark symptom of pulmonary embolism. It occurs due to inflammation of the pleura caused by the obstruction in the pulmonary vasculature.

B. Shortness of breath is one of the most common and early signs of a pulmonary embolism. It occurs due to reduced oxygenation resulting from blocked blood flow in the lungs.

C. Facial weakness that worsens at night is not a manifestation of pulmonary embolism. This symptom is more commonly associated with neurological conditions such as myasthenia gravis.

D. Bloody sputum, or hemoptysis, is a possible symptom of pulmonary embolism. It results from pulmonary infarction, which occurs when lung tissue is damaged due to reduced blood flow.

E. Difficulty speaking is not typically associated with pulmonary embolism. This symptom may be more indicative of neurological events such as stroke.

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Correct Answer is A

Explanation

A. Administering pain medication is the priority action in this scenario. The patient is experiencing significant post-surgical pain, which can impair their ability to breathe deeply and effectively. Addressing pain will improve comfort and facilitate better respiratory effort.

B. Notifying the healthcare provider immediately is not warranted based on the current findings. The amount of drainage (50 mL) is within expected limits for the first hour after surgery, and fluctuation in the water seal chamber indicates the chest tube is functioning properly.

C. Repositioning the patient to the unaffected side may help with comfort but is not the most appropriate action to address the pain or improve respiratory status in this situation.

D. Documenting the findings and continuing to monitor the drain is important but does not address the patient’s immediate need for pain relief.

A. Administer bronchodilator medication before the procedure B. Restrict fluid intake before the procedure C. Perform deep breathing exercises after the procedure D. Place the patient in a supine position during the procedure

Correct Answer is A

Explanation

A. Administering a bronchodilator before postural drainage helps open the airways, making it easier to mobilize and clear secretions during the procedure. This improves the effectiveness of the therapy.

B. Restricting fluid intake before the procedure is not appropriate. Adequate hydration is essential to thin secretions, making them easier to clear during postural drainage.

C. While deep breathing exercises are beneficial for lung expansion and oxygenation, they are not specifically required immediately after postural drainage. The focus is on clearing secretions during the procedure.

D. The supine position is not ideal for postural drainage. The client should be placed in specific positions depending on the lung segment being targeted, such as Trendelenburg or lateral decubitus positions, to facilitate drainage by gravity.

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A nurse is providing teaching to a client about manifestations of pulmonary embolism (PE). Which of the following findings should the nurse include in the teaching? (Select All that Apply.)

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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