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. Crackles are heard in bases. – The nurse encourages the client to cough forcefully:
Crackles are caused by fluid in the alveoli and are often not cleared with coughing. Encouraging coughing may help with mucus, but for fluid-related crackles (e.g., in heart failure), diuretics or other interventions are more appropriate.

B. Wheezes are heard in central areas. – The nurse administers an inhaled bronchodilator:Wheezes result from narrowed airways, commonly seen in asthma or bronchospasm. Bronchodilators relax airway smooth muscle, improving airflow and reducing wheezing.

C. Vesicular sounds are heard over the periphery. – The nurse has the client breathe:
Vesicular breath sounds are normal over the peripheral lung fields. No action is needed when these sounds are heard, so prompting the client to breathe differently is unnecessary.

D. Hollow sounds are heard over the trachea. – The nurse increases the oxygen flow rate:Hollow, tubular sounds (bronchial) are expected over the trachea. These are normal findings and not an indication of hypoxia. Increasing oxygen unnecessarily could be harmful.

A. Temperature of 101.8°F:A temperature above 100.4°F indicates continued fever and inflammation, suggesting the infection is still active. A persistent fever does not reflect clinical improvement and may warrant further assessment or intervention.

B. WBC count of 17,500/mm³:An elevated white blood cell count suggests ongoing infection or inflammation. Normal WBC counts typically range from 4,000 to 11,000/mm³. This elevated value indicates the body is still actively fighting an illness.

C. Respiratory rate of 28:A normal adult respiratory rate is 12–20 breaths per minute. A rate of 28 suggests the patient is still experiencing respiratory distress, possibly due to hypoxia or infection, which does not indicate improvement.

D. Oxygen saturation of 94% on 2L/nasal cannula:An SpO₂ of 94% on low-flow oxygen shows that the patient is maintaining adequate oxygenation with minimal support. This indicates an improving respiratory status and better gas exchange, reflecting clinical progress.