Respiratory Final Review - PC Nursing 152

Hemothorax. A narrowed airway. The need for physiotherapy. Pneumonia.

The ED nurse is assessing a client complaining of dyspnea. The nurse auscultates the client's chest and hears wheezing throughout the lung fields. What might this indicate about the client?

Respiratory System

When a disease infects a host a portal of entry is needed for an organism to gain access. What has been identified as the usual portal of entry for tuberculosis?

Pneumonia Septicemia Meningitis Pulmonary Edema

A client with influenza is admitted to an acute care facility. The nurse monitors the client closely for complications. What is the most common complication of influenza?

Increase oral fluids unless contraindicated. Call the nurse for oral suctioning, as needed. Increase activity. Lie in a low Fowler or supine position.

A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse's assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the client to do?

Administer nebulized bronchodilators and corticosteroids as prescribed. Teach the client to perform deep breathing and coughing exercises. Perform chest physiotherapy once per shift and as needed. Administer prophylactic antibiotics as prescribed.

A nurse is caring for a client receiving skeletal traction. Due to the client's severe limits on mobility, the nurse has identified a risk for atelectasis or pneumonia. What intervention should the nurse provide in order to prevent these complications?

Changing the mask and tubing daily. Posting a no-smoking sign over the clients bed. Assessing the clients respiratory status, orientation, and skin color. Applying an oil-based lubricant to the clients mouth and nose.

A nurse provides care for a client receiving oxygen from a non rebreather mask. Which nursing intervention has the highest priority?

Staphylococcus aureus Mycobacterium tuberculosis Streptococcus pneumoniae Pseudomonas aeruginosa

A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia?

The fact that TB is self-limiting, but can take up to 2 years to resolve The fact that the disease is a lifelong, chronic condition that will affect ADLs The need to work closely with the occupational and physical therapists The importance of adhering closely to the prescribed medication regimen

An adult client has tested positive for tuberculosis (TB). While providing client teaching, what information should the nurse prioritize?

Eat a balanced diet Limit activity for the first 72 hours Take medications as prescribed Use the incentive spirometer every 2 hours.

The nurse is admitting a client to the medical-surgical unit from the PACU. In order to help the client clear secretions and help prevent pneumonia, the nurse should Encourage the client to:

LOC Hemoglobin, hematocrit, and RBC levels O2 Sat levels Extremities for signs of cyanosis

The nurse is caring for a client who is receiving oxygen therapy for pneumonia. The nurse should best assess whether the client is hypoxemic by monitoring the client's:

Client complains of pain INR eh affected area when taking a deep breath Crackles in the lung bases BP of 140/90 HR 94bpm

The nurse is caring for a client who sustained rib fractures in an automobile accident. What symptoms does the nurse recognize as a complication of rib fractures and should immediately be reported to the physician?

Bronchial breath sounds Egophony Crackles at the bases Absent breath sounds

Then ruse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following is expected upon auscultation?

Alert and oriented; peripheral pulses present and strong Vital signs within normal limits; absence of chills and cough Bowel sounds present and active; denies nausea and vomiting Bladder non—distended; Foley catheter draining clear, yellow urine

Which of the following sets of clinical data would allow the nurse to conclude that the nursing actions taken to prevent postoperative pneumonia have been effective?