The patient with oat cell carcinoma has the following clinical findings: low urine output, low serum osmolality, hyponatremia, and elevated urine sodium. The nurse anticipates which of the following as part of the treatment plan? - ANSWER- Phenytoin (Dilantin), 3% saline. RATIONALE:The patient has signs of SIADH which results in production of excessive ADH. Dilantin will inhibit ADH secretion and 3% saline will increase serum sodium. Peep therapy and mechanical ventilation are ordered for the patient with acute respiratory failure. Which of the following is a possible complication? - ANSWER- Barotrauma RATIONALE:The addition of positive end-expiratory pressure will increase alveolar recruitment, prevent atelectasis and improve oxygenation. However, the increase in intrathoracic pressure may lead to pneumothorax or subcutaneous emphysema. The postoperative thoracic surgery patient has bubbling in the water seal drainage chamber of the chest tube. Which of the following interventions is indicated? - ANSWER- avoid high airway pressures RATIONALE:Bubbling in the water seal chamber is due to a pleural air leak, and high airway pressure will either prevent resolution of the current air leak or make it worse. Which clinical sign might patients with both systolic and diastolic heart failure have in common? - ANSWER- Lung crackles