The student nurse is learning how to care for patients who had thoracic surgery following a diagnosis of lung cancer. The intensive care unit nurse is assessing the student's understanding
Which statements by the student indicate the need for further education?
Select all that apply.
1. "I should assess the patient's respiratory system at least every four hours."
2. "I really shouldn't even offer narcotic pain medications to this patient because it will result in severe respiratory depression."
3. "If there are items that the patient needs frequently, I should keep them across the hospital room. This will ensure that the patient will get better faster."
4. "The patient's head of bed should be maintained between 15 and 30 degrees."
5. "The area between the visceral and parietal pleura must be filled with positive pressure to work appropriately, and this can be accomplished with a functioning chest tube."
Correct Answer: 2, 3, 4, 5
Narcotic pain medications should be offered after thoracic surgery to ensure that the patient can perform pulmonary rehabilitation exercises such as coughing, deep breathing, and incentive spirometry. The patient who is using narcotic pain medications to achieve pain control must be monitored for respiratory depression so that it can be treated. This patient should be encouraged to conserve energy. Items that are used frequently should be kept within the patient's reach. The nurse should elevate the head of the bed to 60 degrees, because elevating the head of the bed reduces pressure on the diaphragm and permits optimal lung expansion. The area between the visceral and parietal pleura must be filled with negative pressure to work appropriately. The chest tube is used to achieve negative pressure within this space. The nurse should perform a respiratory assessment at least every four hours.
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