When assisting the health care provider with removal of the chest tube, which instruction should the nurse provide to the client during this procedure?
1. Breathe normally
2. Hold still
3. Hold breath
4. Cough
3
Rationale 1: Breathing normally would not be advised.
Rationale 2: The client needs to do more than hold still.
Rationale 3: The client should be instructed to hold his breath to prevent air from leaking into the pleural space while the tube is removed until an airtight seal can be applied using petroleum gauze.
Rationale 4: Coughing would not be advised.
Global Rationale: The client should be instructed to hold his breath to prevent air from leaking into the pleural space while the tube is removed until an airtight seal can be applied using petroleum gauze. Breathing normally and coughing would not be advised. The client needs to do more than hold still.
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