The nurse is changing a client’s abdominal dressing and notes a separation of the incision line. The underlying tissue is protruding from the wound. The nurse should plan to do which of the following in the initial care of this wound?

Choice A reason: Increasing blood flow back to the heart is not the primary reason for performing arm and shoulder exercises after a thoracotomy. While exercise can improve circulation, the main goal of these specific exercises is to maintain mobility and prevent complications related to immobility.

Choice B reason: Promoting the expansion of the left lung is not the primary purpose of arm and shoulder exercises. While deep breathing exercises and the use of an incentive spirometer are crucial for lung expansion and preventing atelectasis, arm and shoulder exercises focus more on maintaining joint and muscle function.

Choice C reason: Preventing stiffening and loss of function is the primary reason for performing arm and shoulder exercises after a thoracotomy. These exercises help maintain the range of motion in the shoulder and arm, prevent joint stiffness, and reduce the risk of muscle atrophy. Postoperative immobility can lead to significant functional impairments, and these exercises are essential for a smooth recovery.

Choice D reason: Rebuilding the muscle that was removed is not accurate in this context. Thoracotomy involves accessing the thoracic cavity, and while muscle tissue may be affected, the primary goal of postoperative exercises is to maintain existing muscle function and prevent stiffness, not to rebuild muscle tissue.

Choice A reason: Asking if the client would like to see a member of the clergy to receive a blessing can be supportive, but it may not directly address the client’s immediate emotional needs. While spiritual support is important, the nurse should first focus on the client’s expressed concerns about their wife.

Choice B reason: Inquiring if the client has children who can help their wife is practical, but it may not address the client’s emotional distress. The nurse should prioritize providing emotional support and facilitating communication between the client and their family.

Choice C reason: Asking if the client has a living will is important for end-of-life planning, but it does not directly address the client’s emotional concerns. This question is more appropriate for a discussion about advance directives rather than an immediate response to the client’s expressed worries

Choice D reason: Encouraging the client to discuss their feelings with their wife is the most appropriate response. It addresses the client’s emotional needs and promotes open communication between the client and their spouse. This can help alleviate some of the client’s anxiety and ensure that their wife is aware of their feelings and concerns.