Care of Patients with Infectious Respiratory Problems

International normalized ratio (INR): 6.3, Prothrombin time: 35 seconds

A client in the emergency department is taking rifampin (Rifadin) for tuberculosis. The client reports yellowing of the sclera and skin and bleeding after minor trauma. What laboratory results correlate to this condition? (Select all that apply.)

Visiting Nurses for directly observed therapy

A client is being discharged on long-term therapy for tuberculosis (TB). What referral by the nurse is most appropriate?

Assess the client for pain when swallowing.

A client is in the family medicine clinic reporting a dry, sore throat. The provider asks the nurse to assess for odynophagia. What assessment technique is most appropriate?

Teach the client to sneeze in the upper sleeve.

A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination, the nurse notes the client also has a severe headache and muscle aches. What action by the nurse is best?

Facilitate polymerase chain reaction testing.

A client is in the family practice clinic reporting a severe cough that has lasted for 5 weeks. The client is so exhausted after coughing that work has become impossible. What action by the nurse is most appropriate?

Inform the client that antibiotics will be needed for 60 days.

A client seen in the emergency department reports fever, fatigue, and dry cough but no other upper respiratory symptoms. A chest x-ray reveals mediastinal widening. What action by the nurse is best?

Amoxicillin (Amoxil), Ciprofloxacin (Cipro), Doxycycline (Vibramycin)

A hospital nurse is participating in a drill during which many clients with inhalation anthrax are being admitted. What drugs should the nurse anticipate administering? (Select all that apply.)

I will take this medication on an empty stomach.

A nurse has educated a client on isoniazid (INH). What statement by the client indicates teaching has been effective?

Try warm, moist heat packs on your face.

A nurse in a family practice clinic is preparing discharge instructions for a client reporting facial pain that is worse when bending over, tenderness across the cheeks, and postnasal discharge. What instruction will be most helpful?

Provide oral care every 4 hours.

A nurse is caring for several older clients in the hospital that the nurse identifies as being at high risk for healthcare-associated pneumonia. To reduce this risk, what activity should the nurse delegate to the unlicensed assistive personnel (UAP)?

22-year-old client with asthma, Client with well-controlled diabetes, Healthy 72-year-old client, Client who is taking medication for hypertension

A nurse is providing pneumonia vaccinations in a community setting. Due to limited finances, the event organizers must limit giving the vaccination to priority groups. What clients would be considered a priority when administering the pneumonia vaccination? (Select all that apply.)

Older people often have vague symptoms, so an x-ray is essential.

An older adult is brought to the emergency department by a family member, who reports a moderate change in mental status and mild cough. The client is afebrile. The health care provider orders a chest x-ray. The family member questions why this is needed since the manifestations seem so vague. What response by the nurse is best?

Fexofenadine (Allegra)

A nurse working in a geriatric clinic sees clients with cold symptoms and rhinitis. Which drug would be appropriate to teach these clients to take for their symptoms?

Cohort the clients in the same area of the unit.

The charge nurse on a medical unit is preparing to admit several clients who have possible pandemic flu during a preparedness drill. What action by the nurse is best?

Antibiotics started before admission

The emergency department (ED) manager is reviewing client charts to determine how well the staff performs when treating clients with community-acquired pneumonia. What outcome demonstrates that goals for this client type have been met?

Take all antibiotics as directed.

Which teaching point is most important for the client with bacterial pharyngitis?

Breathing so quickly can be dehydrating.

A client admitted for pneumonia has been tachypneic for several days. When the nurse starts an IV to give fluids, the client questions this action, saying I have been drinking tons of water. How am I dehydrated? What response by the nurse is best?

Ask the spouse to explain the fear of visiting in further detail.

A client has been hospitalized with tuberculosis (TB). The clients spouse is fearful of entering the room where the client is in isolation and refuses to visit. What action by the nurse is best?

Alanine aminotransferase (ALT): 180 U/L

A client has been taking isoniazid (INH) for tuberculosis for 3 weeks. What laboratory results need to be reported to the health care provider immediately?

Oral fluconazole (Diflucan)

A client has the diagnosis of valley fever accompanied by myalgias and arthralgias. What treatment should the nurse educate the client on?

What is your occupation?

A client has been admitted for suspected inhalation anthrax infection. What question by the nurse is most important?

Assisting with chest tube insertion, Facilitating pleural fluid sampling, Performing frequent respiratory assessment, Providing antipyretics as needed

A client has been diagnosed with an empyema. What interventions should the nurse anticipate providing to this client? (Select all that apply.)

Educating the client on adherence to the treatment regimen

A client has been diagnosed with tuberculosis (TB). What action by the nurse takes highest priority?