Oxygenation Exam
A nurse is teaching a client who has COPD about ways to facilitate eating. Which of the following statements indicates a need for further teaching. "I will rest for at least 30 minutes before eating" "i will take my bronchodilators after meals" "I will eat five or six small meals each day" "I will choose foods that are not gas forming"
" I will take my bronchodilators after meals" - they should be taken before meals in order to reduce SOB.
A nurse is teaching a client who is taking prednisone for chronic asthma. Which of the following instructions should the nurse include? "Avoid taking nonsteroidal anti-inflammatory drugs." "Rinse your mouth after taking the medication to prevent a yeast infection." "Stop taking the medication if you become nauseous." "Change position slowly when standing up."
"Avoid taking nonsteroidal anti-inflammatory drugs." Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone.
A nurse is caring for a client who is receiving oxygen at 2L/min via nasal cannula. the nurse recognizes the client is receiving which of the following inspired oxygen concentration? 28% 36% 50% 70%
28% With a nasal cannula 1L/min starts at 24% and increases 4% with every additional liter.
What is the normal range for PaO2
80-100 mmHg
What disorders are under the umbrella of COPD
Chronic Bronchitis and Emphysema
Name some nursing interventions / education / considerations for a patient with asthma and a prescription for prednisone
Watch for decreased immune function Monitor for hyperglycemia Advise the client to report black tarry stools Observe for fluid retention and weight gain Monitor the throat and mouth for canker sores
What is status asthmaticus?
a severe, life-threatening asthma attack that is refractory to usual treatment and places the patient at risk for developing respiratory failure. often times endotracheal intubation tube must be used.
A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client?Ipratropium Beclomethasone Acetylcysteine Azelastine
Acetylcysteine. This is a mucolytic
A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? - Administer a SABA (short acting beta 2 agonist) - Obtain a peak flow reading - Administer an inhaled glucocorticoid - Determine the cause of the acute exacerbation
Administer a short acting beta 2 agonist use nebulized high-dose SABA to relieve bronchoconstriction and improve ventilation.
A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the clients parent on administering the medication? - Give the medication in the morning daily - Administer the medication 2 hours before exercise - Give the medication at the onset of wheezing - Administer the granules mixed with 20 oz of water.
Administer the medication 2 hours before exercise. Montelukast should be given daily during the evening, except when being used for exercise-induced bronchospasm. It should then be given 2 hour before exercise, and not given again for 24 hours.
A nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider? -Blurred vision - Palpitations - Constipation - Depression
Depression Montelukast can cause neuropsychiatric effects such as depression, behavior changes, hallucinations, and suicide ideation.
A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? Muscle tremors Drowsiness Excitation Insomnia
Drowsiness. This is a first generation antihistamine
Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? Respiratory depression Drug abuse Drug tolerance Rebound congestion
Drug abuse. it can be altered into meth.
A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client (select all that apply) - Dyspnea - Bradycardia - Barrel chest - Clubbing of the fingers - Deep Respirations
Dyspnea Barrel chest Clubbing of the fingers * as well as - shallow respirations - Tachycardia
Early stage vs Late stage Asthma Attacks. What will we see as far as Alkalosis and acidosis?
Early Stage: - Respiratory alkalosis- hyperventilation & breathing off all the CO2 Late Stage: - Respiratory Acidosis once they become tired out from hyperventilation. They will be in hypoventilation now.
A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include?
Have Lab tests performed at regular intervals Zileuton (a leukotrine modifier) can cause liver injury. The n urse should monitor liver function once a month for 3 months, then every 2-3 months during the first year of treatment.
A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects. (Select all) Muscle tremors Urinary retention Dry mouth Insomnia Tachycardia
Urinary retention Dry mouth
a nurse in the emergency department is caring for a client who is experiencing an acute asthma attack. Which of the following assessments indicates that the respiratory status is declining? (select all) - SaO2 95% - Wheezing - Retraction of sternal muscles - Pink mucous membranes - Tachycardia
Wheezing Retraction of sternal muscles Tachycardia
What are some nursing interventions for patients with Sickle cell Anemia
- IV fluids/ encouraging water - Keep extremeties elevated and extended to prevent swelling and help blood flow - Use warm compress -
What can trigger an asthma attack
- Stress - Environmental allergens such as pollen - Smoke - Pollutants - Sickness - Cold weather - Strenuous activity
Main signs and symptoms of asthma (9)
-Accessory muscle use - Shortness of breath and dyspnea - Tight chest - Tachypnea - Wheezing - Absent breath sounds - Acidosis - Air trapping and prolonged exhalation
What directions would you give a client using an MDI (Metered dose inhaler)
-Shake the inhaler - Breathe out slowly and all the way - Place the MDI 2 finger widths away from mouth (unless a spacer is being used) - with mouth open and tongue flat, tilt the outlet of the MDI so that it is pointed toward the upper back of the mouth - Press down on the MDI and begin to breathe in slowly and deeply, then hold for 10 seconds - After inhalation rinse mouth with water.
A nurse is teaching a client who has asthma how to use a metered dose inhaler. What sequence of steps should the client follow?
1. Inhale deeply and then exhale completely 2. Place lips firmly around mouthpiece 3. Breathe in deeply over 2 to 3 seconds while pushing down on the canister 4. Hold breath for 10 seconds 5. exhale slowly through pursed lips 6. wait 60 seconds between each puff
From what descent is Sickle Cell Anemia more prevalent in?
African Descent
What are the common drugs under the class "Beta 2 adrenergic agonists"?
Albuterol, formoterol, terbutaline
What is Allergic Rhinitis?
Allergic rhinitis is caused by the immune system reacting to an allergen as if it were harmful. This results in cells releasing a number of chemicals that cause the inside layer of your nose (the mucous membrane) to become swollen and excessive levels of mucus to be produced.
A nurse providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide - Consume a high protein diet - Administer the medication with food - Avoid Caffeine while taking this medication - Increase fluids to 1L/ day
Avoid Caffeine while taking this medication. It can increase central nervous system stimulation.
A nurse is providing education to a school-age child who has a new diagnosis of asthma. Which of the following statements should the nurse include in the teaching? "Take cromolyn sodium at the first sign of breathing difficulty" "You should stop playing basketball, but you can swim instead" "Use the Peak expiratory flow meter once per week" "Avoid triggers that cause an attack"
Avoid triggers that cause an attack
A nurse is assessing a client who has COPD. The nurse should expect the clients chest to be which of the following shapes? Pigeon Funnel Kyphotic Barrel
Barrel
A nurse is caring for a client who has an Sao2 of 91% and there are audible wheezes. Which med should the nurse expect to administer Antibioitic Beta Blocker Antiviral Beta 2 agonist
Beta 2 agonist
What is the first treatment for hypercapnia?
BiPap! to expel the high CO2. pushes positive pressure air deep into the lungs and pushes the CO2 out.
The nurse is caring for a client who has heart failure and a history of asthma. The nurse reviews the providers orders and recognizes that clarification is needed for which of the following medications. - Carvedilol - Fluticasone - Captopril - Isosorbide dinitrate
Carvedilol this is a beta 2 blocker and is contraindicated in patients with asthma.
What is the difference between the pathophysiology of chronic bronchitis and emphysema. What symptoms distinguish them?
Chronic Bronchitis: - Bronchial walls become thickened inflammed and mucus often plugs the airways. - Symptoms: cough, sputum production, recurrent infections Emphysema: - damage to alveoli from over-distention, and loss of lung elasticity and inflation of lung tissue. As the alveolar walls continue to break down, the pulmonary capillary bed is reduced in size, decreasing surface area for oxygen exchange to occur. - symptoms: no cough, Barrel chest,
A nurse should recognize that using pseudoeephdrine to treat allergic rhinitis requires cautious use with clients who have. which of the following conditions? Peptic ulcer disease A seizure disorder Anemia Coronary artery disease
Coronary artery disease because pseudoephedrine, an oral sympathomimetic can cause systemic vasoconstriction, it requires cautious use with clients who have severe htn or CAD
What are the common drugs under the class "Mast cell Stabilizers"
Cromolyn
A nurse is caring for a school age child who has mild persistent asthma. Which of the following is an expected finding (select all that apply) - Symptoms are continuous throughout the day - Daytime symptoms occur more than twice a week - Nighttime symptoms occur approximately twice a month - Minor limitations occur with normal activity - Peak expiratory flow (PEF) is greater than or equal to 80% of the predicted value
Daytime symptoms occur more than twice per week Minor limitations occur with normal activity Peak expiratory flow is greater than or equal to 80% of the predicted value
Define Hypoxemia
Decreased PaO2 less than 80 mmHg
A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? Thins mucus Relaxes bronchial smooth muscle Decreases inflammation Increases the cough threshold
Decreases inflammation Beclomethasone is an intranasal glucocorticoid.
A nurse is caring for a client who has COPD. The client tells the nurse "i can feel the congestion in my lungs, and i certainly cough a lot, but I cant seem to bring anything up. Which of the following actions should the nurse take to help this client with tenacious bronchial secretions? - maintaining a semi-fowlers position as often as possible - Adminsitering oxygen via nasal cannula at 2L/min - Helping the client select a low salt diet - Encouraging the client to drink 2 to 3 L of water daily.
Encouraging the client to drink 2 to 3 L of water daily This helps liquify thick secretions and facilitate their expectoration
How does pursed lip breathing work? what is the goal of it?
Goal: to prolong exhalation and increase airway pressure during expiration thus reducing the amount of trapped air and the amount of airway resistance. Also to prevent airway collapse during expiration Inhale through the nose while counting to 2 exhale slowly and evenly against pursed lips while tightening the abdominal muscles count to 4 slowly while prolonging expiration
A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? Headache Sleepiness Hypotension Constipation
Headache. Oral sympathomimetics stimulate adrenergic receptors, causing blood vessel constriction, which may case nervousness, headache, blurred vision, and tremors.
A nurse is reinforcing teaching with a client on the purpose of taking a bronchodilator. Which of the following client statements indicates understanding This med can decrease my immune repsonse I take this med to prevent asthma attacks I need to take this med with food This med has a slow onset to treat my symptoms
I take this med to prevent asthma attacks
a nurse is providing discharge teaching to a client who has a new prescription for prednisone for asthma. Which of the following client statements indicates understanding? I will decrease my fluid intake when taking this med I will expect to have black tarry stools I will take my medication with meals I will monitor for weight loss while on this med
I will take this med with meals taking prednisone on an empty stomach can cause gastrointestinal stress.
A nurse is teaching a client who has COPD and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include? - Check heart rate before each dose - Inspect your mouth for lesions daily - Use this med to relieve an acute attack - Skip the morning dose if you do not have any symptoms
Inspect mouth daily for lesions. Fluticasone is a corticosteroid, which reduces the clients immunity and increases the risk for infection such as candida albicans *MDI= metered dose inhaler
What are the common drugs under the class "Anticholinergics"
Ipratropium, tiotropium
A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? Do not drink anything for 30 min after using the drug. Wait 5 min between using the drug and another inhaled drug. This drug is used to thin respiratory secretions. Check pulse rate after inhaling the drug.
Ipratroprium is an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.
For which of the following reasons should a nurse instruct a client to avoid guaifenesin with combination over the counter products? Over-the-counter cold products can also contain guaifenesin. Blood glucose levels are increased. Rebound congestion is likely. Drug tolerance is likely.
Over-the-counter cold products can also contain guaifenesin.
What is the best way to determine if oxygen therapy has been effective?
PaO2 Value
What does PaO2 represent?
PaO2 is a measurement of the partial pressure of oxygen dissolved in the plasma only. It is measured in mm Hg (millimeters of mercury). The PaO2 does not tell us about the body's total oxygen content, but it does indicate how much oxygen was available in the alveoli to dissolve in the blood.
A client is planning to perform nasotracheal suction for a client who has COPD and an artificial airway. Which of the following actions should the nurse take? - Perform suctioning for up to four passes - Apply suction to the catheter when advancing it into the trachea - Preoxygenate the client with 100% oxygen for up to 3 min - Limit each suction pass to 25 seconds
Preoxygenate the client with 100% oxygen for up to 3 min. * Additionally only suction up to 3 passes * The nurse should advance the catheter without applying suction to prevent injury to the respiratory mucosa. * limit each suction pass to 5-10 seconds.
A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? Suppresses the cough stimulus Reduces surface tension Reduces inflammation Dries mucous membranes
Reduces surface tension. Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.
A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? Blood pressure Apical heart rate Respirations Level of consciousness
Respirations, being that codeine is an opioid agonist.
A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include (Select all) Restlessness Bradycardia Insomnia Muscle pain Anxiety
Restlessness Insomnia Anxiety
A nurse is giving a presentation about chronic bronchitis. Which of the following information should the nurse include as effective for preventing this disorder? - Maintenance of ideal weight - Annual influenza immunization - Smoking Cessation - Regular moderate exercise
Smoking Cessation. Smoking is a major cause of chronic bronchitis.
A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? - Drowsinness - Constipation - Oliguria - Tachycardia
Tachycardia Theophylline can increase cardiac stimulation and cause tachycardia As well as - urinary frequency - Diarrhea - insomnia
A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply) - The medication will stimulate flow of mucus - The medication will prevent wheezing - The medication will open the airways - The medication will reduce inflammation - The medication will decrease coughing episodes
The medication will prevent wheezing The medication will open the airways The medication will decrease coughing episodes
A nurse is teaching the parents of a child who is to start using a MDI to treat asthma. Which of the following information should the nurse include in the teaching? "The spacer increases the amount of medication delivered to the oropharynx" "The spacer increases the amount of medication delivered to the lungs" "Inhale rapidly using the spacer with the MDI" "Cover exhalation slots of the spacer with lips when inhaling"
The spacer increases the amount of medication delivered to the lungs * instead of the mouth.
What are the common drugs under the class "Methylxanthines"
Theophylline
A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? Suppresses the cough stimulus Reduces inflammation Thins and loosens mucus Dries secretions
Thins and loosens mucous
A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/ salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? - Sedation - Increased appetite - White coating in the mouth - Dry oral mucous membranes
White coating in the mouth could indicate oropharyngeal candidiasis.
How does one perform incentive spirometry
after placing your mouth around the mouth piece, you will inhale/inspire slowly and as deeply as you can, and hold for 3 seconds at the end of inspiration. The higher the ball within the spirometer goes, the deeper the breath was. * the book says to repeat this 10 times in succession once and hour, and to cough during and after each session.
Define hypercapnia
an excess of carbon dioxide in the blood
A home health nurse visits a client who has COPD and receives oxygen at 2L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurses priority? -Increase the oxygen flow to 3 L/ min - Assess the clients respiratory status - Call emergency services for the client - Have the client cough and expectorate secretions
assess the clients respiratory status.
What are the common drugs under the class Glucocorticoids?
beclomethasone, Prednisone, fluticasone
What is the Pathophysiology of Asthma
broncho-constriction & wet mucousy lungs. / accumulation of inflammatory cells in the bronchioles. this cuts off o2 to the alveoli Unlike COPD asthma is reversible and often decreases with age.
What are Eosinophils as they relate to asthma?
elevated levels in a blood test indicate that an asthma attack was caused by an allergic reaction
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? "I will use both medications immediately after exercising." "If my breathing begins to feel tight, I will use the cromolyn immediately." "I will be sure to take the albuterol before taking the cromolyn." "I will administer the medications 10 minutes apart."
i will be sure to take the albuterol (bronchodilator) before taking the cromolyn (Mast Cell Stabilizer). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the clients lungs. use before exercise and only 2-5 min apart from each other.
A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the following interventions in the plan? - Restrict the clients fluid intake to less than 2L/day - Provide the client with a low protein diet - Have the client use the early morning hours for exercise and activity - Instruct the client to use pursed lip breathing.
instruct the client to use pursed lip breathing. this lengthens the expiratory phase of respiration and also increases the pressure in the airway during exhalation. This action reduces airway resistance and decreases trapped air for clients who have COPD. ** client with COPD have poor exercise tolerance in the morning due to the accumulation of pulmonary secretions that accumulate while the patient has been recumbent during the night ** COPD patients must consume high calorie high protein to prevent weight loss.
Remember your ABGS! pH? PaCO2? PaO2?
pH: 7.35-7.45 PaCO2: 35-45 PaO2: 80-100
A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? Increases leukocyte activity Blocks muscarinic receptors Causes bronchodilation Reduces inflammation
reduces inflammation by inhibiting the inflammatory response
A college health nurse interprets the peak expiratory flow rate for a student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should base her actions on which of the following information. (Select all that apply) - The student should use his quick relief inhaler - The students asthma is not well controlled - The students peak flow is 50% to 80% of his best peak flow - The student needs to go to the hospital - The nurse should obtain a second expiratory flow rate
the student should use his quick relief inhaler The students asthma is not well controlled The students peak flow is 50 to 80% of his best peak flow The nurse should obtain a second expiratory flow rate
A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. which of the following medications should the nurse expect to administer first? Fluticasone Budesonide Montelukast Albuterol
Albuterol is considered a rescue med because of rapid onset. it promotes brochodilation and supresses histamine release in the lungs
A nurse in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms? - Cromolyn via MDI - Montelukast orally - Budesonide via dry powder inhaler - Albuterol via jet nebulizer
Albuterol via Jet nebulizer
A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? Start at a low dose and gradually increase it. Take the drug as needed for nasal congestion. Allow at least 2 weeks for the full therapeutic effect. Use the drug prior to exercise.
Allow at least 2 weeks for the full therapeutic effect.
A community health nurse is conducting an educational program on various environmental pollutants. The nurse should emphasize that clients who have which of the following disorders are especially vulnerable to ozone effects? Osteoarthritis Basal cell carcinoma Asthma Hypothyroidism
Asthma the ozone exerts it primary adverse effects on the respiratory system, reducing lung function and increasing risk of respiratory infection.
A nurse is caring for a client who has asthma and is taking fluticasone. The nurse should monitor the client for which of the following adverse effects? - Hypoglycemia - Hypertension - Polyuria - Oral candidiasis
Oral candidiasis
A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching. " Ill rinse my mouth after taking this med" "Ill take this med when i get an asthma attack" "Ill take this med once a day in the evening" "Ill use a spacer device when I inhale this med"
I'll Take this med once a day in the evening.
A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? Take the drug as needed for acute asthma. Follow a low-sodium diet. Use an alternate-day dosing schedule. Increase weight-bearing activity.
Increase weight bearing activity. This can minimize bone loss
A nurse is caring for a client who has emphysema and has difficulty with mobility. The client receives home health care and spends most of his day in a reclining chair. Which of the following physiological responses to prolonged immobility should the nurse expect? - Increased insulin production - Decreased RBC production - Decreased sodium excretion - Increased calcium excretion
Increased Calcium excretion because of breakdown of bone tissue.
A nurse is providing dietary teaching for a client who has COPD. which of the following instructions should the nurse include? -Eat 3 large meals each day - Limit water intake with meals - Reduce protein intake - Use bronchodilator 1 hour before eating
Limit water intake with meals to prevent early satiety and increase intake of nutrient dense food. * also instruct patient to eat small frequent meals to conserve energy. increase protein and calories, and use bronchodilator 30 min before eating to reduce risk of bronchospasm.
What medications might induce an asthma flare up?
NSAIDS - Naproxen, Ketorlac Non selective BETA BLOCKERS - olol's
A nurse is assessing a client who has asthma. Which of the following areas should the nurse evaluate as the most reliable indicator of central cyanosis? - Oral mucosa - Conjuctivae - Ear lobes - Soles of the feet
Oral mucosa monitor tongue and lips for evidence of central cyanosis because cyanosis is most evident in areas with minimal pigmentation.
A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? Reduced antitussive effect of dextromethorphan Potentiation of depression of CNS actions Increased renal reabsorption of the dextromethorphan Delayed analgesic effect of the opioid
Potentiation of depression of CNS actions
A nurse is admitting a client who is having an exacerbation of his asthma. When reviewing the providers orders, the nurse recognizes that clarification is needed for which of the following medications? - Propranolol - Theophylline - Montelukast - Prednisone
Propranolol Meds that block beta-2 receptors such as propranolol are contraindicated in clients with asthma.
A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide? -Check the pulse after medication administration - Take the medication with meals - Rinse mouth after administration - Limit caffeine intake
Rinse mouth after administration. use of glucocorticosteroids by metered dose inhaler can allow fungal overgrowth in the mouth.
A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the clients drug level indicates toxicity? Seizures Constipation Normal sinus rhythm Somnolence
Seizures
A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? Use a spacer to improve inhalation. Take the drug at the onset of bronchospasm. Rinse mouth to prevent an oral fungal infection. Take the drug once a day in the evening.
Take once a day in the evening.
A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? The client holds his breath for 10 seconds after inhaling the medication The client takes a quick inhalation while releasing the medication from the inhaler The client waits 10 min between inhalations. The client exhales as the medication is released from the inhaler
The client holds his breath for 10 seconds after inhaling the medication.
Define hypoxic drive and what patients does this drive apply to
The hypoxic drive is a form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle "In COPD, low atrial levels of oxygen serve as the primary drive for breathing. however, in most cases oxygen levels should be maintained between 88% and 92%"
A nurse is in an urgent care center and is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurses highest priority? - Initiating oxygen therapy - Providing immediate rest for the client - Positioning the client in high-Fowlers - Adminsitering a nebulized beta-adrenergic
Administering a nebulized beta-adrenergic. The greatest risk to the clients safety is airway obstruction. Beta Adrenergic medications act as bronchodilators. They provide prompt relief of airflow obstruction by relaxing bronchiolar smooth muscle and are the initial priority intervention when a client has an acute asthma attack
A nurse is assessing a client for hypoxemia during an asthma attack. Which of the following manifestations should the nurse expect? Nausea Dysphagia Agitation Hypotension
Agitation * as well as - dyspnea and hypertension
A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack. - Beclomethasone - Salmeterol - Formoterol - Albuterol
Albuterol
A nurse is caring for a client who has asthma and developed viral pharyngitis. which of the following findings should the nurse expect? Petichiae on the chest and the abdomen WBC 16,000/mm3 Negative throat culture Severe hyperemeia of pharyngeal mucosa
Negative throat culture A client who has viral pharyngitis will have a negative throat culture. A client who has bacterial pharyngitis usually has a throat culture positive for beta-hemolytic streptococcus. * With bacterial pharyngitis a patient will have petechiae on chest and abdomen or both and possibly scarlatiniform rash. They will also have elevated WBC, and severe hyperemia of pharyngeal mucosa, tonsils, tongue, uvula as well as erythema of the tonsils with yellow exudate and petechiae on the soft palate.
A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? Decrease viscosity of nasal secretions Block H2 receptors Prevent histamine from binding to receptors Reduce nasal congestion
Prevent histamine from binding to receptors
A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? High Fever Bradycardia Pain Constipation
Pain from tissue hypoxia and necrosis. As well as: - Low grade fever - Tachycardia
A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? Fever Bruising Polyuria Palpitations
Palpitations
What are the clinical manifestations of COPD
- Tripod Position -Pursed Lip Breathing - Hypercapnia - Air trapping in the lungs - Barrel Chest (seen most commonly with emphysema) - Dyspnea - Lowered O2 Saturations - Weight Loss - Frequent Respiratory infections (seen most commonly with Bronchitis)
