The nurse is caring for a patient following a bilateral lung transplant. When planning postoperative care of the patient, priority is placed on pulmonary hygiene. Which statement provides the best explanation for this priority?
a. Immunosuppressant medications reduce the body's ability to fight infections.
b. During the early postoperative period, atelectasis decreases oxygenation.
c. Pulmonary hygiene reduces the risk of early primary graft dysfunction.
d. Loss of cough reflex results in decreased ability to remove secretions effectively.
D
Nerves of the autonomic nervous system are severed during lung transplant surgery. This results in denervation of the lung and loss of the cough reflex. Loss of this reflex places the patient at greater risk for infection because of the potential inability to clear secretions effectively. Although immunosuppressant medications reduce the body's ability to fight infections, this is a general explanation for all increased risk of infection in transplant recipients. Atelectasis decreases oxygenation. The primary reason for pulmonary hygiene is to expectorate secretions. Primary graft dysfunction is caused by ischemia, surgical trauma, or denervation and is similar to acute respiratory distress syndrome.
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A Latino American female client refuses to participate in an assertiveness training group in the inpatient psychiatric unit. How should a nurse interpret this client's reaction in terms of culture?
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