The nurse assesses a postoperative mastectomy client and notes that breath sounds are diminished in both posterior bases. The nurse's action should be to:

Question

Options

• AEncourage coughing and deep breathing each hour
• BObtain arterial blood gases
• CIncrease O2 from 2-3 L/min
• DRemove the postoperative dressing to check for bleeding

• A
  72% (26)
• B
  3% (1)
• C
  17% (6)
• D
  8% (3)

Explanation

(A) Decreased or absent breath sounds are frequently indicators of postoperative atelectasis. (B) Arterial blood gases are not indicated because there is no other information indicating impendingdanger. (C) Increasing O2 rate is not indicated without additional information. (D) Removing the dressing is not indicated without additional information.

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