Adult Health 2 - Respiratory

A client with deep vein thrombosis suddenly develops dyspnea, tachypnea, and chest discomfort. What should the nurse do first? 1. Elevate the head of the bed 30 to 45 degrees. 2. Encourage the client to cough and deep breathe. 3. Auscultate the lungs to detect abnormal breath sounds. 4. Contact the physician.

1 Patient having a PE, alleviate symptoms THEN inform dr.

A client experiencing a severe asthma attack has the following arterial blood gas: pH 7.33; Pco2 48; Po2 58; HCO3 26. Which of the following orders should the nurse perform first? 1. Albuterol (Proventil) nebulizer. 2. Chest x-ray. 3. Ipratropium (Atrovent) inhaler. 4. Sputum culture.

1 resp. acidosis, need a quick acting bronchodilator

Nasal cannula liter percentages 1 2 3 4 5 6

1 - 24% 2 - 28% 3 - 32% 4 - 36% 5 - 40% 6 - 44%

A nurse notes that a client's arterial blood gas reults reveal a pH of 7.50 and a Pco2 of 30. The nurse monitors the client for which clinical manifestations associated with these arterial blood gas results? Select all the apply: 1) Nausea 2) Confusion 3) Bradypnea 4) Tachycardia 5) Hyperkalemia 6) Lightheadedness

1 2 4 6 would be tachypnea hypokalemia

The nurse is caring for a patient who has been diagnosed with pneumonia. The blood gases report that was taken during admission indicates respiratory acidosis with mild hypoxemia. Repeated arterial blood gas (ABG) analysis reveals that hypoxemia is worsening. Presently, the PaO 2 is 50 mm Hg and SpO 2 is 70%. Which signs or symptoms consistent with decreased oxygen levels may the nurse find in the patient? Select all that apply. 1. Tachypnea 2. Cough 3. Fever 4. Cyanosis 5. Tachycardia

1 4 5

A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client closely for which acid-base disorder that is most likely to occur in this situation? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2

A nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client, knowing that the client is at risk for which acid-base disorder? 1) Metabolic Acidosis 2) Metabolic Alkalosis 3) Respiratory Acidosis 4) Respiratory Alkalosis

2

A nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicated a pH of 7.50 and a Pco2 of 30. The nurse has determines that the client is experience respiratory alkalosis. Which laboratory value would most likely be noted in this condition? 1) Sodium level of 145 2) Potassium level of 3 3) Magnesium level of 2 4) Phosphorus level of 4

2 Alkalosis = hypocalcemia & hypokalemia

The nurse reviews an arterial blood gas report for a client with chronic obstructive pulmonary disease (COPD). pH 7.35; PC02 62; PO2 70; HCO3 34 The nurse should: 1. Apply a 100% non-rebreather mask. 2. Assess the vital signs. 3. Reposition the client. 4. Prepare for intubation.

2 COPD patient will have crazy levels but be fine.

A patient is admitted to the emergency department with suspected carbon monoxide poisoning. Even though the patient's color is ruddy, not cyanotic, the nurse understands that the patient is at risk for decreased oxygen-carrying capacity of blood because of which effect of carbon monoxide? 1. Stimulates hyperventilation, causing respiratory alkalosis 2. Forms a strong bond with hemoglobin, creating a functional anemia 3. Stimulates hypoventilation, causing respiratory acidosis 4. Causes alveoli to overinflate, leading to atelectasis

2 carbon monoxide competes with oxygen and will take over the receptor locations

A client's arterial blood gas values are as follows: pH, 7.31; PaO2, 80 mm Hg; PaCO2, 65 mm Hg; HCO3 −, 36 mEq/ L. The nurse should assess the client for? 1. Cyanosis. 2. Flushed skin. 3. Irritability. 4. Anxiety.

2 resp acidosis causing flushed skin from vasodilation

The nurse is caring for a patient who was admitted to the hospital with a diagnosis of left-sided heart failure. The health care provider asks the nurse to provide continuous positive airway pressure (CPAP) for this patient. What could be the primary motive behind giving CPAP to this patient? 1. To facilitate gas exchange 2. To prevent airway collapse 3. To increase pulmonary edema 4. To improve contractility of the cardiac musculature

2 often used for sleep apnea. increases lung volumes.

Venturi mask liter percentages 2 4 6 8 10 15

2 - 24% 4 - 28% 6 - 31% 8 - 35% 10 - 40% 15 - 60%

The nurse is caring for a client hospitalized with acute exacerbation of chronic obstructive pulmonary disease. Which findings would the nurse expect to note on assessment of this client? Select all that apply. 1. A low arterial PCo2 level 2. A hyperinflated chest noted on the chest x-ray 3. Decreased oxygen saturation with mild exercise 4. A widened diaphragm noted on the chest x-ray 5. Pulmonary function tests that demonstrate increased vital capacity

2 3 diaphragm would be flattened

Which clinical manifestations is the nurse likely to observe in a patient diagnosed with pneumothorax? Select all that apply. 1. Chest pain on expiration 2. Hypotension 3. Tachycardia 4. Absence of coughing 5. Sharp stabbing pain in the chest

2 3 5 hypotension from circulatory collapse pain usually during inspiration coughing

The nurse plans care for a client with chronic obstructive pulmonary disease (COPD), understanding that the client is most likely to experience what type of acid-bases imbalance: 1) Metabolic Acidosis 2) Metabolic Alkalosis 3) Respiratory Acidosis 4) Respiratory Alkalosis

3 COPD = resp. Acidosis cant get Co2 out which is acidic

The nurse teaches a client with chronic obstructive pulmonary disease (COPD) to assess for signs and symptoms of right-sided heart failure. Which of the following signs and symptoms should be included in the teaching plan? 1. Clubbing of nail beds. 2. Hypertension. 3. Peripheral edema. 4. Increased appetite.

3 RHF = JVD, peripheral edema, weight gain

The hemoglobin level of a patient who has pallor and looks weak is 8 g/dL. Upon assessment, the patient's heart rate is 110 bpm and respiratory rate is 30 breaths per minute. Which physiological factor is directly responsible for this condition? 1. Increased metabolic rate 2. Reduced circulating blood volume 3. Decreased oxygen-carrying capacity 4. Decreased inspired oxygen concentration

3 anemic patient does not have enough site for oxygen to bind to.

A client with acute asthma is prescribed short-term corticosteroid therapy. Which is the expected outcome for the use of steroids in clients with asthma? 1. Promote bronchodilation. 2. Act as an expectorant. 3. Have an anti-inflammatory effect. 4. Prevent development of respiratory infections.

3 anti-inflammatory effect

The nurse administers theophylline (Theo-Dur) to a client. To evaluate the effectiveness of this medication, which of the following drug actions should the nurse anticipate? 1. Suppression of the client's respiratory infection. 2. Decrease in bronchial secretions. 3. Relaxation of bronchial smooth muscle. 4. Thinning of tenacious, purulent sputum.

3 decreases BP tachycardia

Simple face mask liter percentages 5-6 7-8 9 and up

35-40% 50% 50-60%

A 34-year-old female with a history of asthma is admitted to the emergency department. The nurse notes that the client is dyspneic, with a respiratory rate of 35 breaths/ minute, nasal flaring, and use of accessory muscles. Auscultation of the lung fields reveals greatly diminished breath sounds. Based on these findings, which action should the nurse take to initiate care of the client? 1. Initiate oxygen therapy and reassess the client in 10 minutes. 2. Draw blood for an arterial blood gas analysis and send the client for a chest X-ray. 3. Encourage the client to relax and breathe slowly through the mouth. 4. Administer bronchodilators.

4 pt needs meds immediately

A client has the following lab values: a pH of 7.55, an HCO3- of 22 mm Hg, and a PCO2 of 30 mm Hg. What should the nurse do? 1. Perform Allen's test 2. Prepare the client for dialysis 3. Administer insulin as ordered 4. Encourage the client to slow down breathing

4 respiratory alkalosis - pt is hyperventilating

A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation should the nurse identify as an example of the clients compensation mechanism? a. Increased rate and depth of respirations b. Increased urinary output c. Increased thirst and hunger d. Increased release of acids from the kidneys

A

A nurse is explaining a chest tube to family members who do not understand where it is placed. What would the nurse tell them? A) "It is inserted into the space between the lining of the lungs and the ribs." B) "I don't exactly know, but I will make sure the doctor comes to explain." C) "It is inserted directly into the lung itself, connecting to a lung airway." D) "It is inserted into the peritoneal space and drains into the lungs."

A

Patient will be skinny, have shortness of breath as the presenting symptom, absent/minimal cough, crackles and a barrel chest. a. emphysema b. bronchitis

A

Renal failure, hypovolemic shock, diarrhea, fistulas, and lactic acidosis put a patient at right for developing what imbalance? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

A

The patient is given ativan to reduce anxiety related hyperventilation. What imbalance should the nurse suspect? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

A

The patient is overdosing from salicylate overdose, what should the nurse expect? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

A

Without ABG's, the patients symptoms are: Hyperventilating hypokalemia/hypocalcemia palpations tremors-tetany-numb lightheaded - confused What is the imbalance? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

A

1) A client is brought to the Emergency Department after passing out in a local department store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse expect to assess in this client? A) Metabolic acidosis B) Respiratory alkalosis C) Metabolic alkalosis D) Respiratory acidosis

A fasting puts body into starvation mode and begins to metabolize own proteins into ketones Ketones= Metabolic acidosis

The nurse determines that the patient is not experiencing adverse effects of albuterol (Proventil) after noting which patient vital sign? a. Pulse rate of 72/minute b. Temperature of 98.4° F c. Oxygen saturation 96% d. Respiratory rate of 18/minute

A adverse effect would be tachycardia

A nurse assesses a client who is admitted with an acid-base imbalance. The client's arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L. What action should the nurse take next? a. Assess client's rate, rhythm, and depth of respiration. b. Measure the client's pulse and blood pressure. c. Document the findings and continue to monitor. d. Notify the physician as soon as possible.

A compensated metabolic acidosis, causes hyperkalemia = cardiac issues

A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? a. Maintenance treatment of asthma b. Treatment of an acute asthma attack c. Reversing bronchospasm associated with COPD d. Treatment of inflammation in chronic bronchitis

A leukotrine = long term treatment of asthma

A nurse evaluates a clients arterial blood gas values (ABGs): pH 7.30, PaO2 86 mm Hg, PaCO2 55 mm Hg, and HCO3 22 mEq/L. Which intervention should the nurse implement first? a. Assess the airway. b. Administer prescribed bronchodilators. c. Provide oxygen. d. Administer prescribed mucolytics.

A without patient airway no other intervention here would be helpful

A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values are pH 7.34, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L. Which assessment should the nurse perform first? a. Cardiac rate and rhythm b. Skin and mucous membranes c. Musculoskeletal strength d. Level of orientation

A metabolic acidosis = cardiac dysrhythmias

What medications should be given to a patient experiencing metabolic alkalosis caused by vomiting? SATA a. ondansteron (zofran) b. acetazolamine c. loperamide (imodium) d. Ativan

A B zofran - for vomiting acetazolamine- gets bicarb out

What would be indicative of a positive mantoux test? SATA a. over 15mm induration b. over 5mm induration for a person with HIV c. over 5mm induation d. over 5 red spot with no induration

A B over 5 mm for a person who is immunocompromised is postitive

A patient with a pneumothorax will present with? SATA a. tachycardia b. dyspnea c. tachypnea d. pink color in face e. Alpha 1 antitripsin deficency

A B C

A nurse assesses a client who is experiencing an acid-base imbalance. The clients arterial blood gas values are pH 7.32, PaO2 94 mm Hg, PaCO2 34 mm Hg, and HCO3 18 mEq/L. For which clinical manifestations should the nurse assess? (SATA) a. Reduced deep tendon reflexes b. Drowsiness c. Increased respiratory rate d. Decreased urinary output e. Positive Trousseaus sign

A B C Metabolic acidosis reduced muscle tone and deep tendon reflexes. lethargy and drowsiness. respiratory system will attempt to compensate for the metabolic acidosis; therefore, respirations will increase rate and depth

Which assessments and interventions should the nurse consider when performing tracheal suctioning? Select all that apply. a. Closely assess the patient before, during, and after the procedure. b. Hyperoxygenate the patient before and after suctioning. c. Limit the application of suction to 20 to 30 seconds. d. Monitor the patient's pulse frequently to detect potential effects of hypoxia and stimulation of the vagus nerve. e. Use an appropriate suction pressure (80-150 mm Hg). f. Insert the suction catheter no further than 1 cm past the length of the tracheal or endotracheal tube.

A B D E

High pressure alarms could be any of the following? SATA a. biting tube b. pneumothorax c. cuff leak d. tube leak e. mucus

A B E biting- give antianxiety

A nurse is planning care for a client following the insertion of a chest tube and drainage system. Which of the following should be included in the plan of care? (Select all that apply) A. Encourage the client to cough every 2 hours B Check for continuous bubbling in the suction chamber C. Strip the drainage tubing every 4 hours D. Clamp the tube once a day E. Obtain a chest x ray

A B E continuous bubbling shows suction is working. This is NOT okay in the water seal chamber

A nurse caring for a patient with chronic obstructive pulmonary disease (COPD) knows that hypoxia may occur in patients with respiratory problems. What are signs of this serious condition? Select all answers that apply. a. Dyspnea b. Hypotension c. Small pulse pressure d. Decreased respiratory rate e. Pallor f. Increased pulse rate

A C E F

Which of the following risk factors exhibited by the client presenting in the Emergency Department would place the client at risk for metabolic acidosis? Select all that apply. A) Abdominal fistulas B) Chronic obstructive pulmonary disease C) Pneumonia D) Acute renal failure E) Hypovolemic shock

A D E

A Bi-pap machine will have? SATA a. high pressure at inspiration b. only pressure at expiration c. low pressure at expiration d. high pressure at expiration

A c try to use this first bc no risk for VAP

What are these medications? Epi isoproterenol (isuprel) albuterol atrovent

Adrenergic bronchodilators

Patient shows hypercapnea and has hypoxemia. They are experiencing dyspnea, confusion and cyanosis. a. low PEEP b. Acute respiratory failure c. pleurodesis d. pneumothorax

B

Patient will have respiratory acidosis, a productive cough,, hypoxia, wheezing/ronchi, JVD, and clubbing. a. emphysema b. bronchitis

B

The nurse determines that a patient is experiencing common adverse effects from the inhaled corticosteroid beclomethasone (Beclovent) after what occurs? a. Hypertension and pulmonary edema b. Oropharyngeal candidiasis and hoarseness c. Elevation of blood glucose and calcium levels d. Adrenocortical dysfunction and hyperglycemia

B

The nurse, who has administered a first dose of oral prednisone to a patient with asthma, writes on the care plan to begin monitoring for which patient parameters? a. Apical pulse b. Daily weight c. Bowel sounds d. Deep tendon reflexe

B

Vomiting, gastric suctioning, excessive antacids, and excessive bicarb replacement therapy can put a patient at risk for developing what imbalance? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

B

When planning teaching for the patient with chronic obstructive pulmonary disease (COPD), the nurse understands that what causes the manifestations of the disease? a. An overproduction of the antiprotease α1-antitrypsin b. Hyperinflation of alveoli and destruction of alveolar walls c. Hypertrophy and hyperplasia of goblet cells in the bronchi d. Collapse and hypoventilation of the terminal respiratory unit

B

Without ABG's, the patient has the following symptoms: dyspnea - decreased o2 tachycardia - dysrhythmias restlessness hypoventilation daytime sleepiness LATE = Headache, blurred vision, confusion, irritable What is the imbalance? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

B

1) The nurse has admitted a client who was brought to the hospital after a morphine overdose. What acid-base imbalance does the nurse expect to observe in this client? A) Respiratory alkalosis B) Respiratory acidosis C) Metabolic alkalosis D) Metabolic acidosis

B Overdose = Resp. Acidosis, not breathing out the Co2 building up

A client with COPD has an acute bronchospasm. The nurse knows that which is the best medication for this emergency situation? a. zafirlukast (Accolate) b. epinephrine (Adrenalin) c. dexamethasone (Decadron) d. oxtriphylline-theophyllinate (Choledyl)

B emergency Adrenergic bronchodilator

A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values? a. Diabetic ketoacidosis in a person with emphysema b. Bronchial obstruction related to aspiration of a hot dog c. Anxiety-induced hyperventilation in an adolescent d. Diarrhea for 36 hours in an older, frail woman

B uncompensated resp. acidosis = from respiratory obstruction issues

When planning care for a patient with chronic lung disease who is receiving oxygen through a nasal cannula, what does the nurse expect? a. The oxygen must be humidified. b. The rate will be no more than 2 to 3 L/min or less. c. Arterial blood gases will be drawn every 4 hours to assess flow rate. d. The rate will be 6 L/min or more

B Dont want to mess up pt's drive to breathe

A nurse is assessing clients who are at risk for acid-base imbalance. Which clients are correctly paired with the acid-base imbalance? (SATA) a. Metabolic alkalosis Young adult who is prescribed intravenous morphine sulfate for pain b. Metabolic acidosis Older adult who is following a carbohydrate-free diet c. Respiratory alkalosis Client on mechanical ventilation at a rate of 28 breaths/min d. Respiratory acidosis Postoperative client who received 6 units of packed red blood cells e. Metabolic alkalosis Older client prescribed antacids for gastroesophageal reflux disease

B C E

A client has a nasogastric tube for decompression that is draining a green fluid. The nurse notes the drainage has been consistently 200 mL or greater for three shifts. What action should the nurse take? A. Document the amount as output in the medical record. B. Irrigate the nasogastric tube with at least 30 mL normal saline. C. Monitor for signs and symptoms of metabolic alkalosis. D. Assess the abdomen for active bowel sounds in all quadrants.

C

A patient is receiving positive pressure mechanical ventilation and has a chest tube. When assessing the water seal chamber what do you expect to find?* A. The water in the chamber will increase during inspiration and decrease during expiration. B. There will be continuous bubbling noted in the chamber. C. The water in the chamber will decrease during inspiration and increase during expiration. D. The water in the chamber will not move.

C

The patient reports long term laxative abuse. What should the nurse suspect? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

C

This test is done by inhalation of radioactive dye to assess for a pulmonary embolism A. Pulmonary function test b. PE scan c. VQ scan d. pet scan

C

What medication should be given to correct metabolic acidosis caused by diarrhea a. ondansteron (zofran) b. acetazolamine c. loperamide (imodium) d. Ativan

C

Without ABG's, the patient symptoms are; Ketones in the urine kussmals anorexia diarrhea Hyperkalemia Hyperventilating (from compensation) what is the imbalance? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

C

What is the most important thing for the nurse to teach the client with a history of diabetes and asthma who has started on albuterol PRN? a. Take Tylenol for headaches when taking albuterol. b. Monitor for orthostatic hypotension every 2 hours when taking albuterol. c. Monitor blood glucose levels every 4 hours when taking albuterol. d. An antianxiety agent may be prescribed to help with nervousness.

C Proventil (ventolin) = albuterol bronchodilator

The client is seen in the Emergency Department with symptoms of a panic attack, including hyperventilation. The nurse suspects that the client may be at risk for which health problem on admission? A) Hypoventilation B) Respiratory acidosis C) Respiratory alkalosis D) Memory loss

C Resp.Alk =anxiety = hyperventilation

The nurse is caring for a client who is being mechanically ventilated. Arterial blood gas analysis reveals a pH of 7.20 and a PaCO2 of 49 mmHg. Which change in ventilator settings should the nurse anticipate? A) Increase in humidification of inspired air B) Decrease of FiO2 from 30% to 25% C) Increased respiratory rate to 30 breaths per minute D) Decreased tidal volume of each breath

C Respiratory acidosis, have to get Co2 out so hyperventilate the pt

A client is taking aminophylline-theophylline ethylenediamine (Somophyllin). For what should the nurse monitor the client? a. Drowsiness b. Hypoglycemia c. Increased heart rate d. Decreased white blood cell count

C Xanthine bronchodilator

Client teaching regarding the use of antileukotriene agents such as zafirlukast (Accolate) should include which statement? a. "Take the medication as soon as you begin wheezing." b. "It will take about 3 weeks before you notice a therapeutic effect." c. "This medication will prevent the inflammation that causes your asthma attack." d. "Increase fiber and fluid in your diet to prevent the side effect of constipation."

C block inflammation, bronchoconstriction and mucus production

Nursing assessment findings of jugular venous distention and pedal edema would be indicative of what complication of chronic obstructive pulmonary disease (COPD)? a. Acute respiratory failure b. Secondary respiratory infection c. Fluid volume excess resulting from cor pulmonale d. Pulmonary edema caused by left-sided heart failure

C cor pulmonale = right sided HF

A patient with severe burns is admitted to the intensive care unit to stabilize and begin fluid resuscitation before transport to the burn center. The nurse should monitor the patient closely for what signs of the onset of burn shock? A) Confusion B) High fever C) Decreased blood pressure D) Sudden agitation

C fluid shift causes it to drop and turns to burn shock

The nurse is planning care for an older client with respiratory acidosis. Which intervention should the nurse include in this client's plan of care? A) Administer prescribed intravenous fluids carefully. B) Administer intravenous sodium bicarbonate. C) Maintain adequate hydration. D) Reduce environmental stimuli.

C fluids can get secretions out of lungs and decrease acidotic state

A client with history of chronic alcoholism and malnutrition has a pH of 7.30 and an HCO3 of 20. The nurse should also expect to see which laboratory value and symptom manifestation? A. Serum Calcium level of 6.2 mEq/L and muscle weakness. B. Serum Magnesium level of 2.8 mcg/L and hypotension. C. Serum Potassium level of 6.0 mEq/L and flaccid paralysis. D. Serum Sodium level of 130 mEq/L and tachycardia.

C metabolic acidosis = hyperkalemia

Low pressure alarms could be any of the following? SATA a. biting tube b. pneumothorax c. cuff leak d. tube leak e. mucus

C D cuff leak- call provider assess connections

What are medications used to treat COPD?

C-TABS corticosteroids theophylline antibiotics (amoxicilin/bactrim) Bronchodilators (ipratropium, atrovert) sympathommetric agents (proventil, ventolin)

2. Oxygen is at the rate of 2 liters/minute through the nasal cannula is prescribed for a client with chronic obstructive pulmonary disease. Which of the following best describes why the oxygen therapy is maintained at relatively low concentration? A) The oxygen will be lost at the client's nostrils if given at a higher level with a nasal cannula B) The client's long history of respiratory problems indicates that he would unable to absorb oxygen at a higher rate C) The cells in the alveoli are so damaged by the client's long history of respiratory problems that increased oxygen levels and reduced carbon dioxide levels likely will cause the cells to burst D) The client's respiratory center is used to high carbon dioxide and low oxygen levels that changing these levels may eliminate his stimulus to breathe

D

A nurse is teaching a home care patient how to do pursed-lip breathing. What is the therapeutic effect of this procedure? A) using upper chest muscles more effectively B) replacing the use of incentive spirometry C) reducing the need for p.r.n. pain medications D) prolonging expiration to reduce airway resistance

D

The nurse is providing patient education related to a patient's central venous access device. Which of the following statements will the nurse make to the patient? a. "These devices are essentially risk free." b. "These devices seldom work for more than a week." c. "The dressing should only be changed by your physician." d. "Heparin may be instilled into the lumen of the catheter to decrease the risk of clotting."

D

The nurse suspects a nonthrombotic occlusion of a central venous catheter. What intervention should the nurse complete first? a. stopping the IV and calling the MD b. increasing the IV rate for 5 minutes c. requesting an order for a chest x-ray d. having patient turn their head or raise their arm

D

Without ABG's, the patients symptoms are: Vomiting - rapid weight change hypoventilation (from compensation) hypokalemia - hypocalcemia tetany-numbness-tingling What is the imbalance? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

D

The nurse is reviewing the latest arterial blood gas results for a client with metabolic alkalosis. Which result indicates that the metabolic alkalosis is compensated? A) pH 7.32 B) PaCO2 18 mmHg C) HCO3 8 mEq/L D) PaCO2 48 mmHg

D PaCO2 is turning acidotic to compensate

A patient's burns are estimated at 36% of total body surface area; fluid resuscitation has been ordered in the emergency department. After establishing intravenous access, the nurse should anticipate the administration of what fluid? A) 0.45% NaCl with 20 mEq/L KCl B) 0.45% NaCl with 40 mEq/L KCl C) Normal saline D) Lactated Ringer's

D potassium chloride would make the hyperkalemia worse

A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance should the nurse assess to prevent complications of this therapy? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

D excess acid loss

What are these medications? guaifensin (robitussin)

Expectorant

Causes: vomiting suctioning excessive antacids

Metabolic alkalosis

What are these medications? diphenhydramine (benedryl) citirizine (zyrtec) loratidine (liantin) nasal azelastine

antihistamines

What are these medications? montelukast (singular) zafirlukast (accolate) zileuton (zyflo)

antileukotrines

What are these medications? opiods benzonatate (tessalon perles)

antitussives

Patient is experiencing an overdose. What should the nurse suspect? a. Respiratory alkalosis b. Respiratory acidosis c. metabolic acidosis d.metabolic alkalosis

b give narcan or romanzicon

What are the two problems associated with PEEP?

barotrauma decreased Cardic output because of pressure

The client is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses the client to be lethargic, confused, and breathing rapidly. What is the nurse's priority response to the situation? A) Stop the infusion and notify the physician because the client is in alkalosis. B) Decrease the rate of the infusion and continue to assess the client for symptoms of alkalosis. C) Continue the infusion, because the client is still in acidosis, and notify the physician. D) Increase the rate of the infusion and continue to assess the client for symptoms of acidosis.

c

What are these medications? sudafed traminic

decongestants

Causes; Diarrhea laxative abuse starvation renal failure fistulas

metabolic acidosis