EDGE #7 - Part 2

Which medications are prescribed for patients with chronic obstructive pulmonary disorder (COPD) because of relaxation of the smooth muscles of the respiratory tract? Select all that apply. A. Anticholinergics B. Glucocorticoids C. Short acting beta2-agonists D. Antibiotics E. Long acting beta2-agonists

A. Anticholinergics Rationale: Anticholinergics relax and enlarge the airways in the lungs, making breathing easier. C. Short acting beta2-agonists Rationale: Beta2-agonists - short acting (SABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction. E. Long acting beta2-agonists Rationale: Beta2-agonists - long acting (LABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction.

A patient with end-stage chronic obstructive pulmonary disorder (COPD) develops sudden dyspnea and chest pain. A spontaneous pneumothorax is suspected. What is the nurse's priority action? A. Maintain oxygenation. B. Place chest tube. C. Intubate. D. Provide pain medicine.

A. Maintain oxygenation. Rationale: Treatment priorities include supplemental oxygenation.

The nurse is evaluating the effectiveness of a small volume nebulizer bronchodilator treatment for a patient with emphysema. Which assessment change indicates an effective outcome of the therapy? Select all that apply. A. Pulse oximetry reading goes from 92% to 94%. B. Audible wheezes are diminished. C. Heart rate increases from 98 to 110 beats per minute. D. The client states "my breathing is the same." E. Facial complexion is a ruddier color.

A. Pulse oximetry reading goes from 92% to 94%. Rationale: In increase in the pulse oximetry indicates increased oxygenation. B. Audible wheezes are diminished. Rationale: Wheezes are a sign on restrictive airway, so a decrease is an encouraging sign.

A patient with COPD reporting chest tightness arrives at the hospital. On assessment, the nurse notes wheezing, cough, elevated blood pressure, and pulse rate. The primary health-care provider prescribes corticosteroids. Which is the most likely outcome of the prescribed therapy? A. Increases the hydration of airway B. Decreases the inflammation of airway C. Aids in bronchial smooth muscle relaxation D. Aids in muscle relaxation around the alveoli

B. Decreases the inflammation of airway Rationale: Inhalation of corticosteroids decreases the inflammation and swelling of airway.

A patient with exacerbation of chronic obstructive pulmonary disorder (COPD) has a respiratory rate of 28 breaths per minute. What action should the nurse take? A. Increase the oxygen. B. Provide comfortable positioning. C. Provide a sedative. D. Encourage slowing of the breathing.

B. Provide comfortable positioning. Rationale: This is the priority. The tachypnea is needed to prevent an acid-base disturbance.

A patient with chronic obstructive pulmonary disorder (COPD) is reporting shortness of breath. On assessment, the nurse finds a pulse rate of 115 beats/min, a blood pressure of 152/94 mm Hg, a temperature of 101°F, and a respiratory rate of 28. Which respiratory test is priority? A. Perform incentive spirometry B. Pulse oximetry C. Obtain a forced expiratory volume D. Peak expiratory flow readings

B. Pulse oximetry Rationale: Pulse oximetry is a noninvasive method of measuring oxygen saturation. This is important information to gather.

The nurse is caring for a patient with COPD who is on ventilator therapy. Which test is most beneficial to evaluate the patient's response to ventilator therapy? A. Spirometry B. Pulse oximetry C. Arterial blood gases (ABG) D. Forced expiratory volume (FEV1)

C. Arterial blood gases (ABG) Rationale: ABG measures oxygenation of the blood, acid-base balance, and the partial pressure of carbon dioxide, and it identifies the patient's response to oxygen and ventilation therapy and medications.

A patient with a severe cough and decreased appetite arrives at the hospital. On assessment, the nurse finds the anterior-posterior diameter as 2:2. After reviewing the assessment findings, what action should the nurse take first? A. Apply 100% nonrebreather mask. B. Request a bronchodilator small volume nebulizer (SVN) treatment. C. Encourage pursed-lip breathing. D. Draw arterial blood gasses.

C. Encourage pursed-lip breathing. Rationale: This will slow the ventilation and allow for air to better escape from the alveoli.

Which is true regarding emphysema? A. It is caused by inflammation of bronchioles. B. It is associated with blood-tinged sputum. C. It is associated with chronic respiratory acidosis. D. It is associated with chronic dilation of bronchioles.

C. It is associated with chronic respiratory acidosis. Rationale: Emphysema is associated with chronic respiratory acidosis