A nurse is planning care for a client who is scheduled for a thoracentesis.
Which of the following actions should the nurse plan to take
A.
Instruct the client to avoid coughing during the procedure
B.
Inform the client that he will be NPO for 6 hr prior to the procedure
C.
Position the client on the affected side for 4 hr following the procedure.
D.
Place the client in the prone position during the procedure
The Correct Answer and Explanation is:
The correct answer is A. Instruct the client to avoid coughing during the procedure.
Explanation:
A thoracentesis is a medical procedure used to remove excess fluid or air from the pleural space, which is the area between the lungs and the chest wall. This procedure is often performed to alleviate symptoms related to pleural effusion or pneumothorax and to analyze the fluid for diagnostic purposes.
Option A: Instruct the client to avoid coughing during the procedure
During a thoracentesis, it is crucial that the client remains as still as possible. Coughing or moving can increase the risk of complications such as pneumothorax (air entering the pleural space) or damage to the lungs and surrounding structures. Instructing the client to avoid coughing helps ensure the procedure is performed accurately and minimizes the risk of complications. This guidance is essential to achieving optimal results and maintaining client safety.
Option B: Inform the client that he will be NPO for 6 hr prior to the procedure
Typically, patients undergoing thoracentesis do not need to be NPO (nil per os, or nothing by mouth) for an extended period before the procedure. Unlike some other procedures that require anesthesia or sedation, thoracentesis is often performed with local anesthesia and does not necessitate NPO status. However, it is always important to follow specific institutional protocols or physician instructions regarding pre-procedural guidelines.
Option C: Position the client on the affected side for 4 hr following the procedure
Post-procedural positioning varies depending on the procedure and patient condition. For thoracentesis, the client is usually positioned upright and slightly leaning forward during the procedure to optimize fluid drainage. After the procedure, it is generally recommended to monitor the client in an upright or semi-Fowler’s position to facilitate lung expansion and prevent complications. Positioning the client on the affected side is not a standard post-procedural requirement.
Option D: Place the client in the prone position during the procedure
The prone position, where the client lies face down, is not appropriate for thoracentesis. The procedure is typically performed with the client sitting upright and leaning forward to expose the back and facilitate access to the pleural space. This positioning helps in locating the fluid or air pocket more effectively and provides better access for the procedure.
In summary, instructing the client to avoid coughing during the procedure is crucial for minimizing complications and ensuring the safety and efficacy of the thoracentesis.