Assessment: The trachea is shifted away from the midline of the neck.

Assessment: Pulse oximetry is 93% on 2 L of oxygen.

Assessment: The client rates pain as 8/10 at the site of the procedure.

Intervention: Request an order for pain medication.

Intervention: Measure oxygen saturation before and after a 12-minute walk.

Intervention: Explain the procedure in detail to the client and the family.

Intervention: Assist the client to the bathroom.

Intervention: Discuss all possible complications with the client.

Assessment: A small amount of drainage from the site is noted.

Intervention: Validate that informed consent has been given by the client.