The nurse is caring for the client in the intensive care unit immediately after removal of the endotracheal tube. Which of the following nursing actions is most important to complete every hour to ensure that the respiratory system is not compromised?
a) Assess capillary refill.
b) Auscultate lung sounds.
c) Obtain vital signs.
d) Monitor heart rhythm.
Answer: Auscultate lung sounds.
If the answers is incorrect or not given, you can answer the above question in the comment box. If the answers is incorrect or not given, you can answer the above question in the comment box.