Oxygenation/gas exchange prepU

A client with sepsis begins having labored breathing, confusion, and lethargy. What complication should the nurse assess for in this client? -Anaphylaxis -Acute respiratory distress syndrome (ARDS) -Chronic obstructive pulmonary disease (COPD) -Mitral valve prolapse

-Acute respiratory distress syndrome (ARDS)

A client experiencing an asthmatic attack is prescribed methylprednisolone (Solu-Medrol) intravenously. The nurse: -Aspirates for blood return before injecting the medication -Assesses fasting blood glucose levels -Encourages the client to decrease caloric intake due to increased appetite -Informs the client to limit fluid intake due to fluid retention

-Assesses fasting blood glucose levels

Severe chest pain is reported by a client during an acute myocardial infarction. Which of the following is the most appropriate drug for the nurse to administer? -Isosorbide mononitrate (Isordil) -Meperidine hydrochloride (Demerol) -Morphine sulfate (Morphine) -Nitroglycerin transdermal patch

-Morphine sulfate (Morphine) Morphine sulfate not only decreases pain perception and anxiety but also helps to decrease heart rate, blood pressure, and demand for oxygen. Nitrates are administered for vasodilation and pain control in clients with angina-type pain, but oral forms (such as isosorbide dinitrate) have a large first-pass effect, and transdermal patch is used for long-term management. Meperidine hydrochloride is a synthetic opioid usually reserved for treatment of postoperative or migraine pain.

Hyperbaric oxygen therapy increases the blood's capacity to carry and deliver oxygen to compromised tissues. This therapy may be used for a client with: -a compromised skin graft. -a malignant tumor. -pneumonia. -hyperthermia.

-a compromised skin graft.

The nurse is assessing a client with lung cancer. What manifestations may suggest that the client has chronic hypoxia? -Edema -Hemoptysis -Constipation -Clubbing

-Clubbing Clubbing refers to the rounding and enlargement of the tips of the fingers and toes. It is a common phenomenon seen in many clients with chronic hypoxia due to respiratory or cardiac disease. Clubbing occurs in lung cancer, cystic fibrosis, and lung diseases such as lung abscess and COPD. Hemoptysis does not result from hypoxia.

Which of the following symptoms should the nurse expect to find as an early symptom of chronic heart failure? -Fatigue -Pedal edema -Nocturia -Irregular pulse

-Fatigue

A client who was diagnosed with type 1 diabetes 14 years ago is admitted to the medical-surgical unit with abdominal pain. On admission, the client's blood glucose level is 470 mg/dl. Which finding is most likely to accompany this blood glucose level? -Cool, moist skin -Rapid, thready pulse -Arm and leg trembling -Slow, shallow respirations

-Rapid, thready pulse

What is the difference between respiration and ventilation? -Ventilation is the process of gas exchange. -Ventilation is the movement of air in and out of the respiratory tract. -Ventilation is the process of getting oxygen to the cells. -Ventilation is the exchange of gases in the lung.

-Ventilation is the movement of air in and out of the respiratory tract.

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: -pleural effusion. -pulmonary edema. -atelectasis. -oxygen toxicity.

-atelectasis. In a client with COPD, an ineffective cough impedes secretion removal. This, in turn, causes mucus plugging, which leads to localized airway obstruction — a known cause of atelectasis. An ineffective cough doesn't cause pleural effusion (fluid accumulation in the pleural space). Pulmonary edema usually results from left-sided heart failure, not an ineffective cough. Although many noncardiac conditions may cause pulmonary edema, an ineffective cough isn't one of them. Oxygen toxicity results from prolonged administration of high oxygen concentrations, not an ineffective cough.

The nurse is teaching the client with a pulmonary disorder about deep breathing. The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client? -"Breathing through your nose first encourages you to sit up straighter to increase expansion of the lungs during inhalation." -"Breathing through your nose first will warm, filter, and humidify the air you are breathing." -"If you breathe through the mouth first, you will swallow germs into your stomach." -"We are concerned about you developing a snoring habit, so we encourage nasal breathing first."

-"Breathing through your nose first will warm, filter, and humidify the air you are breathing." Nasal breathing allows the air to be warmed, filtered, and humidified. Nose breathing does not encourage the client to sit up straight. The purpose of nasal breathing is not to prevent germs from entering the stomach or to discourage snoring.

The parents of a 2-year-old newly diagnosed with tricuspid atresia ask the nurse, "I don't understand why our child's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is most likely to be understood by the parents? -"The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes." -"Chronic hypoxia from your child's heart defect causes effects in various parts of the body, including the fingers." -"The number of red blood cells has significantly increased from the heart defect, resulting in the cells pooling in the fingertips." -"This is a common complication of tricuspid atresia. Unfortunately there is nothing we can do to treat it."

-"The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

A patient has been exercising during his cardiac rehabilitation. What process is noted when oxygen and carbon dioxide are transferred between alveoli and blood in this patient? -Ventilation -Diffusion -Perfusion -Inhalation

-Diffusion

Lung compliance (the ability of the lungs to stretch) is a physical factor that affects ventilation. A nurse is aware that a patient who has lost elasticity in the lung tissue has a condition known as: -Atelectasis -Pulmonary edema -Emphysema -Pleural effusion

-Emphysema

Which measure may increase complications for a client with COPD? -Administration of antibiotics -Increased oxygen supply -Administration of antitussive agents -Decreased oxygen supply

-Increased oxygen supply

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure is decreased from baseline and, on auscultation of his chest, the nurse notes unequal breath sounds. A chest X-ray is immediately ordered by the physician. What diagnosis should the nurse suspect? -Pulmonary embolism -Myocardial infarction (MI) -Heart failure -Pneumothorax

-Pneumothorax

A client is admitted to the emergency department with sudden onset of chest pain. Which prescriptions should the nurse implement immediately? Select all that apply. -Provide oxygen. -Administer nitroglycerin. -Administer aspirin. -Insert a Foley catheter. -Administer morphine. -Administer acetaminophen

-Provide oxygen. -Administer nitroglycerin. -Administer aspirin. -Administer morphine. When emergently managing chest pain, the nurse can use the memory mnemonic MONA to plan care: morphine, oxygen, nitroglycerin, and aspirin. A Foley catheter is not included in the emergent management of chest pain and can be inserted when the pain has been relieved and the client is stable. Acetaminophen is not used to manage chest pain.

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 -Avoiding the use of oxygen to decrease the hypoxic drive -Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise -Increasing pH

-Providing sufficient oxygen to improve oxygenation

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client's lung sounds every 2 hours. Why would the nurse do this? -Pulmonary hypertension -Pulmonary edema -Pulmonary emboli -Pulmonary atelectasis

-Pulmonary edema

A client returns to the telemetry unit after an operative procedure. Which diagnostic test will the nurse perform to monitor the effectiveness of the oxygen therapy ordered for the client? -Pulse oximetry -Thoracentesis -Spirometry -Peak expiratory flow rate

-Pulse oximetry

A nursing instructor is discussing asthma and its complications with medical-surgical nursing students. Which of the following would the group identify as complications of asthma? Choose all that apply. -Status asthmaticus -Respiratory failure -Pertussis -Atelectasis -Thoracentesis

-Status asthmaticus -Respiratory failure -Atelectasis

A preterm infant is experiencing cold stress after birth. For which symptom should the nurse assess to best validate the problem? -shivering -hyperglycemia -apnea -metabolic alkalosis

-apnea

To drain the apical sections of the upper lobes of the lungs, the nurse should place the client in which position? -left side with a pillow under the chest wall -side-lying position, half on the abdomen and half on the side -high-Fowler's position -Trendelenburg position

-high-Fowler's position

An adolescent who is immobilized in a cast to stabilize a recently fractured femur suddenly develops chest pain, dyspnea, diaphoresis, and tachycardia. The nurse should further assess the client for: -atelectasis. -pneumonia. -pulmonary edema. -pulmonary emboli.

-pulmonary emboli. Chest pain and dyspnea in an immobilized adolescent with a large bone fracture suggest a fat embolus. With this condition, fat droplets, rather than a thrombus, are transferred from the marrow into the general blood stream by the venous-arterial route, possibly reaching the lung or brain. Atelectasis may develop; however, the onset of signs and symptoms is usually more gradual and subtle. Pneumonia can occur; however, the signs and symptoms usually do not develop suddenly. Pulmonary edema should not be a problem in a healthy adolescent who has sustained a fracture.