The nurse assesses a client with a pleural chest tube inserted to treat a pneumothorax. Which findings require immediate notification to the provider? Select all that apply.

The client complains of chest pain when breathing deeply.

New onset of subcutaneous emphysema

Constant bubbling in the water seal chamber,

The eyelets of the chest tube are visible.

An occasional bubble appears in the water seal chamber when the client exhales

Answer and Explanation

Correct Answer : B,C,D

Rationale:

A. Mild to moderate chest pain with deep inspiration is expected after chest tube insertion due to pleural irritation or tissue trauma. Pain should be managed with analgesics, but it does not require immediate provider notification unless accompanied by respiratory distress, hypotension, or other signs of complication.

B. Subcutaneous emphysema (air under the skin, often felt as crepitus) indicates air leaking from the pleural space into surrounding tissue. This may signal tube displacement, a worsening pneumothorax, or a new pleural leak, all of which require urgent provider notification. Severe cases can compromise the airway.

C. The water seal chamber should only bubble intermittently during exhalation or coughing. Continuous or constant bubbling indicates an air leak, suggesting tube malfunction or pleural space compromise. This can prevent proper lung re-expansion and requires prompt provider evaluation.

D. Chest tube eyelets should remain entirely within the pleural cavity. If they are visible, the tube is malpositioned, which can prevent drainage and worsen the pneumothorax or cause tissue damage. This is an urgent finding requiring immediate attention.

E. This is expected behavior for a properly functioning chest tube. Intermittent bubbling with exhalation or coughing shows that the tube is patent and air is being expelled from the pleural space. It does not require provider notification.

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Free Nursing Study Resources

Correct Answer is ["44"]

Explanation

Step 1: Use the formula
Flow rate (gtt/min) = (mL/hr × Drop factor) ÷ 60

Step 2: Insert known values
mL/hr = 175
Drop factor = 15 gtt/mL

Flow rate = (175 × 15) ÷ 60
Flow rate = 2,625 ÷ 60
Flow rate = 43.75 gtt/min

Step 3: Round to the nearest whole number
43.75 = 44 gtt/min

Final Answer: 44 gtt/min

A. Neurological status for changes in level of consciousness B. Lung sounds for the presence of crackles or diminished breath sounds. C. Abdominal girth and tenderness D. Vital signs for hypotension and tachycardia.

Correct Answer is B

Explanation

Rationale:

A. Neurological status is important to assess, as hypoxemia can lead to confusion or altered mental status. However, this is a secondary assessment after identifying and addressing the primary cause of hypoxemia. It is not the first action.

B. Lung sounds should be assessed first because the client is experiencing shortness of breath with a low oxygen saturation (88%, below the normal 95–100%). In acute pancreatitis, respiratory complications such as pleural effusion or acute respiratory distress syndrome (ARDS) can develop. Assessing lung sounds immediately helps determine the cause of hypoxemia, guides oxygen therapy, and identifies the need for urgent interventions like supplemental oxygen or respiratory support.

C. Abdominal girth and tenderness are relevant for monitoring pancreatitis progression and ascites, but these assessments do not directly address the acute respiratory compromise. They are not the first priority in a client with hypoxemia.

D. Vital signs for hypotension and tachycardia are important because circulatory instability can worsen oxygen delivery. While vital signs should be checked promptly, auscultating lung sounds provides more specific information about respiratory compromise, which is the immediate priority in a client with low oxygen saturation.

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The nurse assesses a client with a pleural chest tube inserted to treat a pneumothorax. Which findings require immediate notification to the provider? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse prepares to administer 500 mL of normal saline to infuse at 175 mL/hr for a client who is vomiting. The IV tubing has a drop factor of 15 gtt/mL. How many gtt/min will the client receive? Round to a whole number.

Correct Answer is ["44"]

Explanation

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Correct Answer is B

Explanation

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