NUR 222 - Ch 11 - PrepU

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education?

The patient should take the medication an hour before meals or 2 hours after a meal. (p. 346)

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%

60 mm Hg; 90% (p. 333)

Bronchiectasis is

A condition in which the lungs' airways become damaged, making it hard to clear mucus.

A physician orders a beta2 adrenergic-agonist agent {a bronchodilator} that is short-acting and administered only by inhaler. The nurse knows this would probably be {generic name}

Albuterol (p. 331).

Which is the strongest predisposing factor for asthma?

Allergy (p. 342)

bronchodilators relieve bronchospasm in three ways

Alter smooth muscle tone; Reduce airway obstruction; Increase oxygen distribution (p. 330)

A client is diagnosed with a *chronic respiratory disorder*. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis?

Anxiety (p. 341)

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for?

Atelectasis can result as a complication of bronchiectasis

A client is at risk for emphysema. When reviewing information about the condition with the client, which would the nurse emphasize as the most important environmental risk factor for emphysema?

Cigarette smoking (p. 328)

Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What manifestations validate the nurse's concern? (Select all that apply.)

Compromised gas exchange; Decreased airflow; Wheezes

Which symptoms are considered *primary symptoms of COPD*?

Cough (p. 329)

A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which commonly used medication will the nurse educate the patient about?

Cromolyn sodium (p. 346)

Which of the following is a symptom diagnostic of emphysema?

Dyspnea (p. 328)

A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder?

Emphysema (p. 327)

The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client

Exhales hard and fast with a single blow (p. 345)

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)?

Exposure to tobacco smoke acts as a risk factor (p. 328)

In which grade of COPD is the forced expiratory volume (FEV) less than 30%?

III (p. 329)

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?

Oxygen through nasal cannula at 2 L/minute (p. 333)

Asthma is cause by which type of response?

IgE-mediated (p. 343)

A client is admitted to a health care facility for treatment of chronic obstructive pulmonary disease. Which nursing diagnosis is most important for this client?

Impaired gas exchange related to airflow obstruction (p. 328)

It is important to teach patients how to manage an acute episode of dyspnea. Which of the following teaching points should be included in the lesson? Select all that apply.

Keep arms supported and relaxed with pillows; Breathe out through pursed lips; Make each breath longer and longer. (p. 337)

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?

Lung sounds (p. 340)

Histamine, a mediator that supports the inflammatory process in asthma, is secreted by

Mast cells (p. 342)

A client being seen in the E.D. has labored respirations, inspiratory and expiratory wheezes. Oxygen saturation is 86%. The client was nonresponsive to an albuterol (Ventolin) inhaler and I.V. methylprednisolone {Solu-Medrol}. The nurse administers the following prescribed treatment first:

Oxygen therapy through a non-rebreather mask (p. 349)

A child is having an asthma attack and the parent can't remember which inhaler to use for quick relief. The nurse accesses the child's medication information and tells the parent to use which inhalant?

Proventil (p. 331)

A patient with asthma is prescribed a short acting beta-adrenergic {SABA} for quick relief. Which of the following is the most likely drug to be prescribed?

Proventil (p. 331)

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?

Providing sufficient oxygen to improve oxygenation (p. 333)

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

Respiratory acidosis can indicate this problem

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis is the acid-base imbalance in question (p. 333)

A nurse administers albuterol {Proventil}, as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?

Respiratory rate of 22 breaths per minute (p. 335)

The nurse provides health teaching to a patient who has been prescribed an inhaler for corticosteroid administration. Which of the teaching points would the nurse include? Select all that apply:

Shake the inhaler for up to 6 seconds to mix the medication; Take a deep breath with the mouth wide open as the inhaler is depressed; Exhale through pursed lips. (p. 332)

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

Sputum and a productive cough (p. 327)

To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations?

Streptococcus pneumonia and Haemophilus influenzae (p. 332)

A nurse is developing a teaching plan for a client with asthma. Which teaching point has the highest priority?

Take ordered medications as scheduled (p. 345)

The nurse is assigned to care for a patient in the ICU who is diagnosed with status asthmaticus. Why does the nurse include fluid intake as being an important aspect of the plan of care? (Select all that apply.)

To combat dehydration; To loosen secretions; To facilitate expectoration (p. 348)

The hormone brain natriuretic peptide (BNP) is produced by which of the following?

Ventricles of the heart (p. 335)

The condition Atelectasis is

a complete or partial collapse of a lung or lobe of a lung — develops when the tiny air sacs {alveoli} within the lung become deflated

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for:

atelectasis can result from the inability to cough effectively (p. 335)

During a subclavian vein central line insertion, the client's O2 saturation drops rapidly. He complains of shortness of breath & becomes tachypneic. The nurse suspects the client has developed a pneumo-thorax. Further assessment findings supporting the presence of a pneumo-thorax include:

diminished or absent breath sounds on the affected side. (p. 340).

hypercapnia

excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration.

The classification of grade 1 COPD is defined as

mild COPD. (p. 329)

The classification of Stage II of COPD is defined as

moderate COPD (p. 329)

The classification of Stage III of COPD is defined as

severe COPD (p. 329)

The classification of Stage IV of COPD is defined as

very severe COPD. (p. 329)

You are caring for a client with obstructive pulmonary disease. Your nursing care includes diagnoses, outcomes, and interventions for what?

your nursing care should plan for Atelectasis (p. 334)