The nurse is caring for a client with chronic bronchitis who has a productive cough. What intervention should the nurse implement to promote effective airway clearance?

Correct Answer: A

Rationale: Correct Answer: A: Encourage fluid intake of at least 2 liters per day. Rationale: 1. Adequate hydration helps to keep respiratory secretions thin and easier to expectorate. 2. Increased fluid intake helps to prevent dehydration, which can thicken secretions and worsen cough. 3. Hydration is essential for overall health and helps to maintain optimal pulmonary function. Summary: B: Limiting activity may lead to decreased respiratory effort and impaired airway clearance. C: Cough suppressants can hinder the body's natural mechanism to clear secretions. D: Providing supplemental oxygen may help with oxygenation but does not directly promote effective airway clearance.

Correct Answer: A

Rationale: The correct answer is A because continuous bubbling in the water seal chamber indicates an air leak in the chest tube system, which can lead to pneumothorax. Immediate action is needed to prevent respiratory compromise. Choice B is incorrect because drainage of 50 mL in the past hour is within normal limits for a chest tube output. Choice C, tidaling in the water seal chamber, is a normal finding indicating proper functioning of the chest tube system. Choice D is incorrect because although the chest tube dressing intact with no drainage is a good sign, it does not require immediate action compared to an air leak.

Correct Answer: C

Rationale: The correct answer is C: Lose weight to reduce airway obstruction. This recommendation is most appropriate as excess weight can contribute to airway obstruction in obstructive sleep apnea. Losing weight can help reduce the amount of fatty tissue around the airway, improving airflow during sleep. A: Sleeping in a supine position may worsen obstructive sleep apnea by causing the tongue and soft tissues to block the airway. B: Limiting fluid intake in the evening may help reduce nighttime trips to the bathroom but does not directly address the underlying cause of obstructive sleep apnea. D: Avoiding the use of CPAP even if symptoms improve is not recommended as CPAP therapy is an effective treatment for obstructive sleep apnea and helps maintain open airways during sleep.

Correct Answer: B

Rationale: The correct answer is B: High Fowler's with arms supported on a table. This position allows for easier access to the thoracic cavity, facilitating the thoracentesis procedure. High Fowler's position also helps the client breathe more comfortably and reduces the risk of complications. A: Supine with arms at the sides would not provide optimal access to the thoracic cavity. C: Prone with a pillow under the chest would hinder access to the thoracic cavity and compromise the procedure. D: Side-lying with the affected side down could also impair access to the thoracic cavity and make the procedure more challenging.

Correct Answer: B

Rationale: The primary goal of oxygen therapy for a client with chronic bronchitis is to improve oxygen delivery to tissues. In chronic bronchitis, the airways are inflamed and narrowed, leading to decreased oxygen exchange. Providing supplemental oxygen helps increase oxygen levels in the blood, improving oxygen delivery to tissues throughout the body. This can alleviate symptoms such as shortness of breath and fatigue. Choice A is incorrect because oxygen therapy primarily focuses on increasing oxygen levels, not reducing carbon dioxide levels. Choice C is incorrect as oxygen therapy does not directly address mucus production. Choice D is incorrect as the goal of oxygen therapy is not specifically to prevent pneumonia, although adequate oxygenation can support overall respiratory health and reduce the risk of complications.