The patient has an order for Penicillin-G 1 gram intramuscularly. The instructions read: reconstitute the vial with 9.8 mL of normal saline to yield 2 grams in 10 mL. How many mL will the nurse administer per dose? Round the answer to the nearest whole number. Record numeric answer only.

Choice A reason: Reducing anxiety about tracheostomy self-care aids long-term adjustment but is not the immediate priority. A new tracheostomy requires vigilant monitoring for complications like infection or skin breakdown at the stoma, which can lead to serious infections or tissue damage if not addressed promptly.

Choice B reason: Reassuring the client that the tracheostomy is temporary may provide emotional support but is not the priority. Many tracheostomies are permanent, and assuming temporariness may mislead. Immediate care focuses on preventing complications like stoma infections, making skin assessment more critical than reassurance.

Choice C reason: Frequent assessment of the skin around the tracheostomy stoma prevents complications like infection, pressure ulcers, or tissue necrosis. The stoma is prone to irritation from secretions and tube movement, which can foster bacterial growth and skin breakdown, necessitating vigilant monitoring to ensure healing and prevent serious infections.

Choice D reason: Referring to a support group aids long-term coping but is not the immediate priority. A new tracheostomy requires focus on preventing physical complications like infection or skin breakdown at the stoma, which pose immediate risks, making skin assessment more urgent than psychosocial support.

Choice A reason: Frequent ambulation improves lung expansion and secretion mobilization but does not thin secretions. In pneumonia, thick secretions result from inflammation and dehydration, requiring hydration to reduce viscosity, making ambulation a supportive, not primary, intervention for thinning secretions effectively.

Choice B reason: Coughing and deep breathing mobilize secretions in pneumonia, aiding clearance, but do not thin consistency. Thick secretions require hydration to reduce viscosity, making coughing more effective, but it is secondary to fluid intake, which directly alters mucus composition for easier expectoration.

Choice C reason: Increasing fluid intake thins secretions in pneumonia by hydrating the body, reducing mucus viscosity. Adequate hydration ensures thinner secretions, facilitating expectoration and reducing airway obstruction risk, making this the most effective intervention for addressing thick secretions in this condition.

Choice D reason: Incentive spirometry promotes lung expansion and prevents atelectasis but does not thin secretions. While it aids clearance by improving airflow, hydration is needed to alter mucus viscosity, making spirometry a supportive measure, not the primary intervention for thinning secretions in pneumonia.