A client is admitted with a chemical injury to the esophagus after ingestion of an alkaline substance. The client states, "I am having trouble breathing because of these air bubbles in my neck." Which action by the nurse is most appropriate?
a. Continue assessing the client while anoth-er nurse calls the health care provider.
b. Ask the client to rate the pain and prepare to administer pain medication.
c. Have the client cough and deep breathe, then assess his or her lung sounds.
d. Give the client small sips of water to see whether he or she has dysphagia.
A
Ingestion of alkaline substances is dangerous because of their potential to fully penetrate the esophagus, leading to perforation. "Air bubbles" in the neck (subcutaneous emphysema) would lead the nurse to suspect this complication. The nurse needs to continue assessing the client and must stay with him or her, but because this is an emergency, someone else must notify the pro-vider immediately. The nurse should not administer pain medication at this time. Coughing and deep-breathing exercises will not be beneficial to the client. If the client's esophagus has perfo-rated, having the client drink can cause more problems.
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