A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate?

Choice A reason: Tracheal deviation toward the unaffected side indicates a tension pneumothorax, where air trapped in the pleural space compresses the lung and mediastinum, impairing venous return and cardiac output. This life-threatening condition requires immediate provider notification to prevent cardiovascular collapse and ensure urgent intervention.

Choice B reason: Intermittent minor bubbling in the water seal chamber is normal, indicating air escaping from the pleural space as the pneumothorax resolves. This does not require immediate provider notification unless it becomes vigorous, suggesting a new or worsening air leak, unlike tracheal deviation.

Choice C reason: Crepitus around the insertion site suggests subcutaneous emphysema, where air leaks into tissues. Small amounts often resolve spontaneously as the lung heals, requiring monitoring but not immediate notification, unlike tracheal deviation, which signals a critical tension pneumothorax needing urgent action.

Choice D reason: Difficulty coping with the chest tube is a psychosocial issue, not a physiological emergency. It warrants nursing support but not immediate provider notification, as it does not pose an immediate threat like tracheal deviation, which indicates a life-threatening tension pneumothorax.

Choice A reason: Blood pressure of 94/62 mm Hg indicates hypotension, possibly from hypovolemia or anesthesia, but is less life-threatening than hypoxia. Oxygen saturation of 82% risks organ damage, making blood pressure secondary, requiring fluid or vasopressor support after addressing hypoxia.

Choice B reason: Heart rate of 110 beats/minute (tachycardia) suggests compensation for hypovolemia or pain but is less critical than oxygen saturation of 82%. Hypoxia risks rapid organ damage, while tachycardia is addressed after oxygenation, making it a lower priority in postoperative assessment.

Choice C reason: Oxygen saturation of 82% indicates severe hypoxia, risking brain and organ damage within minutes. Postoperative clients are prone to atelectasis or pulmonary edema, impairing gas exchange. Immediate oxygen therapy or airway management is critical, making this the most urgent finding.

Choice D reason: Urine output of 50 mL/hr is normal (0.5–1 mL/kg/hr), indicating adequate renal perfusion. Unlike oxygen saturation of 82%, which signals critical hypoxia, normal urine output does not require immediate attention, reflecting stable hydration and kidney function.