A client who underwent pneumonectomy two days ago has the nursing diagnosis of ineffective airway clearance related to increased secretions and decreased coughing effectiveness due to pain. Which among the following nursing care interventions can help the client achieve effective airway clearance? 

Help the client cough and deep breathe every 1 or 2 hours (while awake) during the first 24 to 48 postoperative hours
Place the client on semi or high-Fowler’s position once the vital signs are stable
Schedule coughing and deep breathing sessions at times when pain medication is maximally effective

Explanation

•Patients should be placed upright to help lung expansion and facilitate ventilation with minimal effort. Lateral positioning should be avoided due to risk of compressing remaining lung because the mediastinum is no longer held in place on both sides by lung tissue.

•Closed-chest drainage is not used after pneumonectomy because there is no lung to reexpand.

•Increasing the volume of air in the lungs promotes expulsion of secretions.

Visit our website for other NCLEX topics now!