The practical nurse (PN) is caring for a client scheduled for a bronchoscopic procedure. After the charge nurse administers the IV sedative, which action should the PN implement?

Choice A reason: Reinforcing the expected outcomes of surgery is important in the preoperative phase to ensure the client understands the procedure, risks, and expected results. However, once the IV sedative has been administered, the client may be in a sedated state and may not be able to retain this information effectively. Therefore, this action is more appropriate before administering the sedative rather than after. The focus should shift to monitoring the client's vital signs and ensuring their safety.
Choice B reason: Determining if the client needs to void is generally part of the preoperative preparations to ensure that the bladder is empty, reducing the risk of complications during the procedure. While it is important, this step should be completed before administering the sedative to ensure the client is alert and able to communicate their needs. Once sedated, the client’s immediate needs should focus on their vital signs and overall stability.
Choice C reason: Auscultating all lung fields is a valuable assessment to ensure the client has clear airways and adequate ventilation. However, once the client is sedated, continuous monitoring of vital signs, including respiration, is more critical. Auscultating lung fields might be appropriate before the procedure to establish a baseline, but it is not the immediate priority after administering sedation.
Choice D reason: Monitoring blood pressure is the most crucial action to implement after administering the IV sedative. Sedatives can cause changes in cardiovascular stability, including hypotension or hypertension. Continuous monitoring of blood pressure helps detect any adverse effects of the sedation and ensures prompt intervention if necessary. Maintaining stable blood pressure is vital for the safety and well-being of the client during and after the procedure.

Choice A reason: Checking mucous membranes can provide information about the client's hydration status. Dry mucous membranes can be a sign of dehydration, which may contribute to decreased urine output. This assessment is important to determine whether the client has adequate fluid balance.
Choice B reason: Ensuring that the catheter tubing is straight is essential to confirm that there are no kinks or obstructions that could be causing the reduced urine flow. Any obstruction in the catheter tubing could lead to a sudden decrease in urine output, and this check helps ensure patency.
Choice C reason: Auscultating lung sounds is crucial to assess for fluid overload or pulmonary complications, which can be associated with renal transplant patients. Abnormal lung sounds could indicate issues that may indirectly affect urine output and overall kidney function.
Choice D reason: Determining the dryness of bed linens helps assess whether the client might have experienced a leakage of urine outside the catheter system. If the bed linens are wet, it could indicate an issue with the catheter or bladder function that needs to be addressed.
Choice E reason: Irrigating the catheter to assess patency is a direct method to determine whether there is any blockage or obstruction in the catheter. This procedure helps ensure that the catheter is functioning correctly and allows for appropriate urine drainage.