SHERPATH: Asthma

A patient presents with nasal flaring, intercostal retractions, and chest tightness. The nurse notes diminished breath sounds over both lungs. After administering albuterol and intravenous magnesium sulfate, which assessment finding indicates treatment has been effective? A. Heart rate of 122 beats/min B. Persistent barking cough C. Supraclavicular retractions D. Inspiratory and Expiratory wheezing

D. Inspiratory and Expiratory wheezing Inspiratory and expiratory wheezing heard after treatment indicates improved movement of air in the lungs and effectiveness of treatment.

A patient with asthma presents with complaints of dyspnea on exertion. The nurse notes hyperresonance on percussion. Which action should the nurse take? A. Administer albuterol inhaler. B. Administer fluticasone tablet. C. Obtain a STAT chest x-ray. D. Teach the patient the pursed-lip breathing technique.

D. Teach the patient the pursed-lip breathing technique. Hyperresonance on percussion indicates air trapping. The nurse should teach the patient the pursed-lip breathing technique to prevent hyperinflation.

A patient presents to the emergency department with dyspnea. The patient's vital signs are temperature 98.6° F, blood pressure 160/100 mm Hg, heart rate 90 beats/minute, respiratory rate 25 breaths/min, and functional oxygen saturation of 80%. Peak expiratory flow rate (PEFR) is 52%. Which orders should the nurse prioritize for this patient? Select all that apply. A. Albuterol B. Oral aspirin C. Oral metoprolol D. Supplemental oxygen E. Intravenous magnesium sulfate

A. Albuterol Albuterol, a short-acting β2-agonist, would be given to a patient with an acute asthma exacerbation. D. Supplemental oxygen Supplemental oxygen should be administered to treat the patient's hypoxemia.

A patient presents to the emergency department with difficulty breathing and tightness in the chest. The patient reports being confined to bed or the couch all day, unable to perform any activities. The patient's peak flow measures 67% of the patient's personal best, according to the electronic medical record. Which action should the nurse take first? A. Give albuterol. B. Give inhaled fluticasone. C. Administer an intravenous (IV) fluid bolus. D. Administer oral albuterol.

A. Give albuterol. Albuterol is a short-acting β2-agonist and is administered, sometimes with an oral corticosteroid, to control a mild-to-moderate exacerbation of asthma.

A patient with a history of asthma presents with wheezing and dyspnea and reports tightness of the chest. On assessment, the patient appears agitated and is fidgeting. The patient's vital signs are: blood pressure 160/90 mm Hg, temperature 99.0° F, heart rate 95 beats/min, and respiratory rate 19 breaths/min. Which complication of asthma is this patient likely experiencing? A. Hypoxemia B. Heart failure C. Bacterial pneumonia D. Accessory muscle use

A. Hypoxemia Hypoxemia can lead to agitation and irritability.

Which patient education is critical for Ms. Asher to prevent and/or prepare for future attacks? A. Identification of asthma triggers B. The importance proper nutrition C. Keeping asthma inhalers on hand at all times D. Proper method for use of the peak flow meter

A. Identification of asthma triggers Ms. Asher should be encouraged to identify triggers to prevent future attacks.

The nurse is caring for a patient who reports sudden onset of dyspnea and chest tightness. Oxygen saturation is 79%. The nurse notes a peak flow of 42%. Nebulized albuterol is administered without improvement. Oxygen saturation after administration of albuterol is 81% and the patient is becoming fatigued. Which action would the nurse take next? A. Notify the provider B. Document the findings C. Give repeat dose of albuterol D. Prepare patient for intubation

A. Notify the provider The nurse would notify the provider if the patient's symptoms have not improved after treatment.

A nurse is caring for a child with a history of asthma. The nurse anticipates that the provider will order which test to determine whether the child's asthma is related to allergies? A. Serum immunoglobulin E (IgE) B. Chest x-ray C. Measurement of arterial blood gases (ABGs) D. Sputum culture

A. Serum immunoglobulin E (IgE) IgE and eosinophil counts can be used to determine if the child's asthma is due to an allergic tendency.

Which patient is most likely experiencing an acute asthma attack? A. A patient with fever and cough B. A patient with wheezing and nasal flaring C. A patient with productive cough and chills D. A patient with no lung sounds on the left side

B. A patient with wheezing and nasal flaring Wheezing and nasal flaring indicate lower airway obstruction and use of accessory muscles, which are signs of an acute asthma attack.

A patient arrives in the emergency department with severe wheezing and dyspnea that started 10 minutes ago. Which medications should the nurse anticipate administering to this patient? Select all that apply. A. Nonsteroidal anti-inflammatory drugs (NSAIDs) B. Albuterol C. Fluticasone D. Oral penicillin E. Intravenous (IV) methylprednisolone

B. Albuterol Albuterol is a short acting β2-agonist and would be given to dilate the bronchioles in patients with acute asthma exacerbations. E. Intravenous (IV) methylprednisolone Methylprednisolone is a corticosteroid that may be used to treat inflammation in acute asthma exacerbations. IV corticosteroids are used for management of acute asthma exacerbations.

A patient is experiencing an acute asthma attack. The nurse understands that which common triggers may be the cause of this attack? Select all that apply. A. Walking inside B. Allergic reaction to cats C. Intake of dairy products D. Exposure to air pollution E. Prolonged heat exposure

B. Allergic reaction to cats Allergic asthma can result from exposure to allergens. C. Intake of dairy products Dairy products can cause excessive mucus production and lead to asthma exacerbations in patients with asthma. D. Exposure to air pollution Exposure to air pollution can lead to lung irritation and an acute asthma attack.

Which aspects of the immune response are thought to be involved in the development of asthma? Select all that apply. A. Antibody formation B. Lack of conditioning C. Drainage of lymph fluid D. Immunoglobulin E (IgE) response to allergens E. Passive immune response

B. Lack of conditioning Lack of conditioning is a part of the immune response in the development of asthma. Children who are not exposed to pathogens, in day care or school settings for example, are at higher risk. D. Immunoglobulin E (IgE) response to allergens An IgE response to allergens is seen in the development of asthma.

The nurse is caring for a patient with a history of asthma who reports severe dyspnea and the presence of chest tightness for 3 days that has escalated in the last few hours. The nurse notes, functional oxygen saturation of 87%, inspiratory and expiratory wheezes, and forced expiratory volume in 1 second (FEV1) of 23%. Which nursing actions are appropriate for this patient? Select all that apply. A. Administer albuterol. B. Provide supplemental oxygen. C. Administer intravenous (IV) corticosteroids. D. Give oral pain medication. E. Administer intravenous (IV) antianxiety medication.

B. Provide supplemental oxygen. The patient's symptoms indicate a moderate, acute asthma exacerbation. Supplemental oxygen is administered to treat the patient's hypoxemia. C. Administer intravenous (IV) corticosteroids. The patient's symptoms indicate a moderate, acute asthma exacerbation. IV corticosteroids would be administered for an acute asthma exacerbation

A patient is being seen in the emergency department for an acute asthma attack. Initial forced expiratory volume in 1 second (FEV1) is 70%. After the initial dose of albuterol, FEV1 is 75%. Which provider order would the nurse carry out first? A. Obtain STAT measurement of arterial blood gases (ABGs). B. Repeat albuterol dose. C. Obtain electrocardiogram. D. Administer pain medication.

B. Repeat albuterol dose. The nurse would administer another dose of albuterol to continue to help reduce the patient's symptoms. Initially, three doses of albuterol are usually given in the ED depending on the patient's response to the medication.

Which nursing assessment finding during an acute asthma attack suggests a serious complication requiring immediate intervention? A. Inspiratory wheezing B. Intercostal retractions C. Diminished breath sounds D. Hyperresonance on percussion

C. Diminished breath sounds Diminished breath sounds indicate poor air movement and require immediate intervention.

The nurse is caring for a patient with chest tightness and difficulty breathing. The nurse notes accessory muscle use, wheezes, and a peak flow of 50%. After oral corticosteroids and a short-acting β2-agonist have been administered, which assessment findings would indicate the need for further treatment? A. Temperature of 98.9° F B. Respiratory rate of 24 breaths/min C. Diminished breath sounds D. Moist mucous membranes

C. Diminished breath sounds Diminished breath sounds indicate impeded air flow in the lungs and would require further treatment.

Which actions have priority during Ms. Asher's current asthma attack to ensure she is calm and focused on normal breathing? Select all that apply. A. Administer albuterol. B. Provide oral salmeterol. C. Provide a comfortable place for her to sit. D. Identify environmental triggers of the attacks. E. Reassure her that the attack will eventually end.

C. Provide a comfortable place for her to sit. Finding a comfortable place for Ms. Asher to sit will help her to remain calm. E. Reassure her that the attack will eventually end. The nurse should reassure Ms. Asher that the attack will end with proper treatment. Providing reassurance will help keep this patient calm.

During a routine wellness visit, a patient reports asthma symptoms occurring approximately three times per week. The symptoms do not interfere with the patient's sleep, and on assessment, forced expiratory volume in 1 second is within normal range. Which intervention can the nurse anticipate for this patient? A. Intravenous (IV) corticosteroids B. Antihistamine tablets C. Short-acting β2 agonist D. Home oxygen supplementation

C. Short-acting β2 agonist A short-acting β2-agonist would be given to a patient with a mild asthma exacerbation.

List the pathophysiologic mechanisms that occur in asthma in order. Bronchioles constrict Exposure to trigger Lung dysfunction Blood vessels dilate

Exposure to trigger Blood vessels dilate Bronchioles constrict Lung dysfunction