MED SURG FINAL EXAM WITH COMPLETE UPDATED SOLUTIONS(2023-2023) VERIFIED ANSWERS

Fluctuations in the water-seal chamber occur when the client breathes.
Crepitus forms at the chest tube insertion site.
Intermittent bubbling occurs in the water-seal chamber. Gentle bubbling occurs in the suction
control chamber. Drainage is collecting in the drainage chamber. - ANSWERS,Fluctuations in the
water-seal chamber occur when the client breathes.
Intermittent bubbling occurs in the water-seal chamber.
Gentle bubbling occurs in the suction control chamber.
Drainage is collecting in the drainage chamber.
Fluctuations in the water-seal compartment (or tidal movements) indicate normal function of the
system as the pressure in the tubing changes with the client's respirations. There also should be
intermittent bubbling in the water-seal chamber, indicating that air is being removed from the
pleural cavity by the system. Gentle bubbling in the suction control chamber indicates that the
proper suction level has been reached. Drainage is expected to collect in the drainage chamber after
a lobectomy. Crepitus indicates that air is leaking into the subcutaneous tissues. The physician
should be notified of this finding.
The nurse is planning care for a child with a pneumothorax. The nurse adds the nursing diagnosis,
"Risk for injury related to potential dislodgement of chest tube" to the care plan. When writing the
care plan, what should the nurse be sure to include as interventions?
Keep dry gauze at the bedside
Ensure a pair of hemostats are at the bedside
Monitor pulse oximetry readings
Assess lungs as directed by the physician or as the client's condition warrants
Maintain chest tube bottle in an upright position and below the level of the chest - ANSWERS,Ensure
a pair of hemostats are at the bedside
Monitor pulse oximetry readings
Assess lungs as directed by the physician or as the client's condition warrants
Maintain chest tube bottle in an upright position and below the level of the chest
If the tube becomes dislodged from the child's chest, the nurse must apply Vaseline gauze and an
occlusive dressing to prevent air leakage into the pleural space. A pair of hemostats should be kept
at the bedside to clamp the tube should it become dislodged from the drainage container. Pulse
oximetry and lung assessments help ensure proper placement of the chest tube. To maintain proper
drainage, the bottle must be kept upright and below the level of the chest.
The nurse has received a change-of-shift report. The nurse should assess which client first?
a 72-year-old admitted 2 days ago with a blood alcohol level of 0.08
a 36-year-old with chest tube due to spontaneous pneumothorax with current respiratory rate 18
breaths/min, oxygen saturation 95% on oxygen at 2 L per nasal cannula a 28-year-old who is 2 days
postappendectomy with discharge prescriptions written and whose husband is waiting to take her
home
a 62-year-old admitted with a recent gastrointestinal (GI) bleeding whose hemoglobin is 13.8 g/dL
(138 g/L) - ANSWERS,a 72-year-old admitted 2 days ago with a blood alcohol level of 0.08
The nurse should closely monitor the client admitted with an elevated blood alcohol level for several
hours for signs and symptoms of withdrawal, administering sedation as needed; delirium tremens,
the most severe form of withdrawal, usually peaks at 48 to 72 hours following the last drink. The
client with the chest tube is not in any d