The nurse is caring for a client with a chest tube who accidentally disconnects the tube from the drainage system when trying to get out of bed. The nurse takes which immediate action?
1. Has the client hold a breath
2. Places the client in a prone position
3. Immerses the end of the tube in sterile saline
4. Places a sterile dressing over the end of the chest tube
3
Rationale: If the drainage system is broken or interrupted or the tube disconnects, the end of the tube should be placed in a bottle of sterile saline held below the level of the chest. A new drain-age system is then immediately obtained and set up. Placing a sterile dressing over the discon-nection site will not prevent complications resulting from the disconnection. Placing the client in the prone position and asking the client to hold his or her breath are incorrect and may cause res-piratory difficulty. The nurse should perform an assessment on the client and contact the physi-cian.
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Which patients are at increased risk for adverse drug events? (Select all that apply.)
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a. "It refers to the bluish color of the cervix in pregnancy." b. "It means the cervix is softening." c. "The doctor was able to flex the uterus against the cervix." d. "That refers to a positive sign of pregnancy."
A nurse is counseling a mother about the immunologic properties of breast milk. The nurse integrates knowledge of immunoglobulins, emphasizing that breast milk is a major source of which immunoglobulin?
A) IgA B) IgG C) IgM D) IgE