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Chapter 34: Problem 149

A client is found in the room holding his hands to his throat and his lips are turning blue. Which action by the nurse is most appropriate? A. Lying the client on the floor and administering abdominal thrust. B. Ask the client to cough. C. Placing both fists around the abdomen above the umbilicus and administering abdominal thrust. D. Attempting a blind finger sweep.

Short Answer

Expert verified
Option C is most appropriate: Placing both fists around the abdomen above the umbilicus and administering abdominal thrusts.

Step by step solution

01

Assessing the Situation

Observe the client to determine the severity of the situation. The client is holding his hands to his throat and his lips are turning blue, indicating that he is choking and unable to breathe.
02

Choosing the Appropriate Response

Consider the actions listed and their implications:A. Lying the client on the floor and administering abdominal thrusts may not be feasible immediately and is less practical.B. Asking the client to cough may not be helpful if the client cannot breathe properly.C. Placing both fists around the abdomen above the umbilicus and administering abdominal thrusts is recommended for choking.D. Attempting a blind finger sweep could push the obstruction further and is not recommended.
03

Implementing the Action

Based on the assessment and analysis, the most appropriate action is:Option C - Placing both fists around the abdomen above the umbilicus and administering abdominal thrusts since this is the recommended procedure for severe choking.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

choking emergency management
In a choking emergency, it's crucial to act quickly and correctly to prevent severe consequences. The primary goals are to remove the airway obstruction and restore breathing. First, observe the victim for signs of choking, such as clutching the throat, inability to speak, or changing skin color. Always assess the situation before taking action.

Determine if the individual can cough forcefully or make sounds. If they can, encourage them to cough to expel the object. If they are unable to do so, immediate intervention is necessary as it indicates a complete blockage, and lack of oxygen is causing the bluish skin (cyanosis).
nursing intervention
Nursing interventions are lifesaving procedures carried out to manage and stabilize patients during emergencies. In the case of choking, it is essential to perform these steps systematically:
  • Quickly identify the severity of the choking.
  • Stay calm and act confidently to reduce panic for both the patient and any bystanders.
  • Perform the appropriate action based on the assessment.
The nurse should prioritize effective techniques that are less likely to cause harm. For partial obstructions, encourage coughing. For complete obstructions, abdominal thrusts (also known as the Heimlich maneuver) are recommended. Avoid methods like the finger sweep unless the object is visible and can be removed without pushing it deeper.
abdominal thrust procedure
The abdominal thrust procedure is a first aid technique used to treat severe choking by exerting pressure on the diaphragm, expelling the foreign object blocking the airway. Here鈥檚 how to perform it effectively:

  1. Stand behind the person and wrap your arms around their waist.
  2. Make a fist with one hand and place it just above the person's navel (belly button).
  3. Grasp your fist with your other hand.
  4. Perform quick, upward thrusts, as if trying to lift the person off the ground.
  5. Continue until the object is expelled or the person becomes unresponsive.
If the person becomes unconscious, carefully lower them to the ground and begin CPR, if you are trained. Immediate emergency medical assistance should be sought regardless of the outcome.

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