Editing Reduction of Risk Potential – RN Practice Questions (section)

==Question 13==
Thirty minutes after a thoracentesis, a client becomes acutely short of breath with sharp right-sided chest pain. Breath sounds are markedly diminished on the right, the heart rate is 124 beats per minute, and oxygen saturation has fallen from 96 percent to 87 percent. What complication should the nurse suspect and what is the priority action?
# Re-expansion pulmonary edema; administer the ordered diuretic.
# Pneumothorax; administer oxygen, place the client in high Fowler position, notify the provider, and prepare for a chest radiograph.
# Anxiety reaction; coach the client in pursed-lip breathing.
# Pulmonary embolism; ambulate the client to improve circulation.

'''Answer:''' Option 2. Pneumothorax; administer oxygen, place the client in high Fowler position, notify the provider, and prepare for a chest radiograph.

''Rationale:'' Pneumothorax is the most common serious complication of thoracentesis, presenting with sudden dyspnea, pleuritic pain, diminished or absent breath sounds on the affected side, tachycardia, and desaturation. Oxygen and an upright position support ventilation while the provider is notified and imaging is obtained, with chest tube insertion anticipated. Option 1 describes a different complication that follows removal of very large volumes and presents with bilateral crackles. Option 3 dismisses objective hypoxemia. Option 4 misattributes the findings and ambulation would be unsafe.