A nurse is reinforcing teaching with a client who is to start taking montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?

A. Facial flushing

Facial flushing is not typically associated with atelectasis. Instead, it may occur in conditions such as oxygen toxicity or fever.

B. Increasing dyspnea

Atelectasis is a condition characterized by the collapse or partial collapse of a portion of the lung. Common findings in a client with atelectasis include increasing dyspnea (shortness of breath) due to impaired gas exchange and reduced lung function. As the affected lung tissue collapses, ventilation and oxygenation are compromised, leading to difficulty breathing.

C. Decreasing respiratory rate

A decreasing respiratory rate is not typically observed in a client with atelectasis. Instead, respiratory rate may increase as the body attempts to compensate for the impaired gas exchange and oxygenation resulting from lung collapse.

D. Dry cough

While coughing is a common symptom of atelectasis, it is typically associated with a productive cough rather than a dry cough. A dry cough is more commonly associated with conditions such as viral respiratory infections or allergic reactions. In atelectasis, the cough may be productive as the body attempts to clear mucus or other secretions from the affected airways.

A. Turn off the ventilator alarms before suctioning the client's airway.

This choice is incorrect because it goes against standard practice. Ventilator alarms are critical for monitoring the patient's respiratory status and detecting any issues with the ventilator or the patient's airway. Turning off alarms before suctioning can lead to missed alarms and potentially dangerous situations for the patient.

B. Provide mouth care every 10 to 12 hr with hydrogen peroxide.

This choice is incorrect because using hydrogen peroxide for mouth care is not recommended. Hydrogen peroxide can be irritating to the mucosa and may cause harm to the patient's oral tissues. Instead, gentle oral care with an appropriate solution, such as a mouthwash specifically designed for oral hygiene in ventilated patients, is preferred. Mouth care should also be provided more frequently than every 10 to 12 hours to maintain oral hygiene and prevent complications such as ventilator-associated pneumonia.

C. Place the head of the client's bed at 40° when supine.

This choice is correct. Proper positioning of the patient is crucial for optimizing ventilation and preventing complications such as aspiration and ventilator-associated pneumonia. Elevating the head of the bed to 40 degrees when the patient is in a supine position helps to minimize the risk of aspiration by promoting drainage of secretions away from the airway and improving lung expansion.

D. Reposition the client every 4 hr.

This choice is not directly related to care for clients receiving mechanical ventilation. While repositioning the patient every 4 hours is important for preventing pressure ulcers and maintaining skin integrity, it is not specific to mechanical ventilation care. However, it is still an important aspect of overall patient care, particularly for patients who are immobile or confined to bed for extended periods.