After your patient's pleural space has been drained during their Thoracentesis, the fluid in the glass jars has a pus-like appearance.
This fluid is most likely the result of a:
Chylothorax.
Pneumothorax.
Hemothorax.
Empyema.
The Correct Answer is D
Choice A rationale
A chylothorax refers to the accumulation of chyle, a milky, lymphatic fluid, in the pleural space. This typically results from disruption of the thoracic duct, often due to trauma or malignancy. The fluid's characteristic milky appearance is due to its high triglyceride content, not a pus-like consistency.
Choice B rationale
A pneumothorax is the presence of air in the pleural space, leading to lung collapse. It is characterized by respiratory distress and diminished breath sounds, not the presence of fluid with a pus-like appearance. This condition involves gas, not liquid, accumulation in the pleural cavity.
Choice C rationale
A hemothorax is the accumulation of blood in the pleural space, usually due to trauma or a ruptured blood vessel. The fluid would appear bloody, not pus-like. While blood can become infected, a primary hemothorax itself presents as serosanguineous or frank blood, differing from purulent exudate.
Choice D rationale
Empyema refers to the accumulation of pus in the pleural space, most commonly caused by bacterial infection. The pus-like appearance of the drained fluid is a direct indication of a significant inflammatory and infectious process, where leukocytes, necrotic debris, and microorganisms are present, forming purulent exudate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The arterial blood gas values indicate a primary respiratory issue. The pH of 7.10 is significantly below the normal range (7.35-7.45), indicating acidosis. The PaCO2 of 70 mmHg is elevated above the normal range (35-45 mmHg), directly causing the acidosis by increasing carbonic acid. The bicarbonate (HCO3) level of 24 mEq/L is within the normal range (22-26 mEq/L), signifying no renal compensation has occurred, thus it is uncompensated. This pattern is characteristic of respiratory acidosis.
Choice B rationale
Partial compensation would be evident if the bicarbonate level was outside its normal range, indicating renal attempts to buffer the acidosis. Since the HCO3 is 24 mEq/L, which is within the normal range, there is no evidence of the kidneys compensating for the respiratory acidosis. Therefore, this option is incorrect as compensation is absent.
Choice C rationale
Metabolic alkalosis is characterized by an elevated pH and an elevated bicarbonate level, with potential compensatory changes in PaCO2. The patient's pH is acidotic (7.10) and the bicarbonate is normal (24 mEq/L), which directly contradicts the parameters for metabolic alkalosis. Therefore, this interpretation is not supported by the given ABG values.
Choice D rationale
Metabolic acidosis would present with a low pH and a low bicarbonate level, with potential compensatory changes in PaCO2. The patient's pH is low, but the primary driver is the elevated PaCO2, and the bicarbonate is normal. This set of values does not align with the criteria for metabolic acidosis.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Suctioning should be performed only when clinically indicated, such as in the presence of visible secretions, adventitious breath sounds, or a decline in oxygen saturation. Routine, unnecessary suctioning can cause mucosal trauma, hypoxemia, and increased risk of infection. This "as needed" approach minimizes potential complications and preserves airway integrity.
Choice B rationale
Hyperoxygenating the patient with 100% oxygen for 30-60 seconds prior to suctioning helps to create an oxygen reserve in the lungs and minimize the risk of hypoxemia during the procedure. Suctioning can transiently reduce lung volumes and gas exchange, and pre-oxygenation mitigates this by saturating hemoglobin and dissolved plasma oxygen.
Choice C rationale
Suctioning for longer than 10-15 seconds on each pass significantly increases the risk of hypoxemia, atelectasis, and vagal stimulation leading to bradycardia. Prolonged suctioning depletes oxygen from the airways and can cause physiological distress. Brief passes allow for reoxygenation between attempts and minimize adverse events.
Choice D rationale
Performing hand hygiene prior to suctioning is a critical infection control measure. This practice reduces the transmission of microorganisms from the healthcare provider's hands to the patient's airway, thereby preventing healthcare-associated infections like ventilator-associated pneumonia. Adherence to strict aseptic technique is paramount in airway management.
Choice E rationale
Suctioning should never be performed while inserting the catheter into the artificial airway. Applying negative pressure during insertion can cause significant mucosal trauma, bleeding, and increased risk of infection by pulling tissue into the catheter lumen. Suction should only be applied intermittently and during withdrawal of the catheter, to remove secretions effectively and safely.
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