A nurse is teaching a newly hired LPN about trach care. The nurse should include that the inner cannula should be cleaned with a brush and then dried with a

A. Clear drainage from the ear:Clear ear drainage is not a typical symptom of sinusitis and may suggest a different issue such as otitis media with tympanic membrane rupture or cerebrospinal fluid leak in rare cases.

B. Ear pain when lying down:While referred ear pain can occur in sinusitis due to pressure, pain that worsens when lying down is more commonly associated with otitis media or Eustachian tube dysfunction. It is not specific to sinusitis.

C. Generalized pain in the upper teeth:Upper tooth pain is a classic sign of maxillary sinusitis due to the proximity of the sinus cavities to the upper dental roots. Inflammation or pressure in the sinuses can cause discomfort that radiates to the upper jaw.

D. Maxillary sinuses nontender on percussion:Lack of tenderness over the maxillary sinuses suggests absence of significant inflammation. In sinusitis, percussion or palpation over the sinuses typically produces tenderness due to mucosal swelling and pressure buildup.

A. “The client needs immediate intubation and mechanical ventilation.”Intubation may be required in severe respiratory failure, but not all clients with pulmonary embolism need mechanical ventilation. Suggesting intubation without assessment of the client’s respiratory effort or ABGs is premature.

B. "Maybe the client has respiratory distress syndrome."ARDS is can impair oxygenation, but it is not the most likely explanation for persistent low oxygen saturation in PE. PE more commonly causes ventilation-perfusion mismatch due to blocked blood flow.

C. "The client is breathing too slowly and it interferes with oxygenation."Slow breathing could impair ventilation, but in PE, oxygenation is impaired because blood flow to parts of the lung is blocked, not necessarily due to a respiratory rate issue.

D. "The blood clot interferes with perfusion in the lungs."Pulmonary embolism obstructs blood flow in the pulmonary arteries, resulting in areas of the lung being ventilated but not perfused. This causes a ventilation-perfusion mismatch and leads to reduced oxygenation despite supplemental oxygen.