Ch 30

After receiving education on the correct use of emergency drug therapy for asthma, which statement by the client indicates a correct understanding of the nurse's instructions?

"I must have my emergency inhaler with me at all times."

Which statement by a client with chronic obstructive pulmonary disease (COPD) and a 10 pound (4.5 kg) weight loss indicates the need for additional follow-up instruction?

"I should consume plenty of fluids with my meal."

The nurse is evaluating understanding of the treatment regimen for a client newly diagnosed with asthma. Which of these statements by the client indicates understanding of the regimen?

"I will take the long acting beta agonist even when my breathing seems OK."

The client says, "I hate this stupid COPD." What is the best response by the nurse?

"You sound fed up with managing your illness."

A client recently diagnosed with asthma has a prescription to use an inhaled medication with a spacer. The nurse evaluates the client has correct understanding of the use of an inhaler with a spacer when the client states which of these?

-"If the spacer makes a whistling sound, I am breathing in too rapidly." -"I should hold my breath for at least ten seconds after inhaling the medication."

The nurse is providing preoperative teaching for the client with lung cancer for whom a lobectomy is planned. Which of these does the nurse include in the preoperative education session?

-"You will wake up with a drain in your chest which removes blood and allows the remaining lung to expand." -"Plan to request pain medication before your pain becomes severe." -"You may have a tube in your throat connected to a mechanical ventilator to assist you with breathing."

The nurse is providing teaching for a client who has been newly diagnosed with lung cancer and will be undergoing radiation therapy. Which of these points would be covered in the teaching session?

-Do not expose the site to sun. -Fatigue may occur. -Changes in taste may occur.

The nurse is caring for a client who has had a lobectomy and placement of a chest tube 8 hours ago. When performing an initial assessment, which of these requires immediate follow up?

200 mL red drainage from chest tube over 2 hours

The nurse on a medical surgical unit is planning bed assignments for a new admission who has cystic fibrosis (CF) and is infected with Burkholderia cepacia. Which of these room assignments is most appropriate for this client?

A private room with a bathroom

The nurse is assessing a client admitted with status asthmaticus. The nurse finds a sudden absence of wheezing in the lung fields and sets which of these as the priority action?

Activation of the rapid response team to secure an airway

A client with acute exacerbation of asthma has been admitted to the medical surgical unit for treatment. The client is reporting increased shortness of breath with inspiratory and expiratory wheezes. When planning care for this client, which medication will the nurse administer first?

Albuterol-2 inhalations

When caring for the client returning from thoracotomy and placement of a chest tube, the client reports severe pain. What does the nurse do first?

Assess location and quality of pain.

The school nurse is teaching a group of adolescents about risk factors for lung cancer and lung disease. Which of these would be included in the discussion?

Cigarette smoking

The charge nurse is making assignments for clients cared for on the intensive care stepdown unit. Which client will the charge nurse assign to the RN who has floated from the pediatric unit?

Client with acute asthma episode who is receiving oxygen at FiO2 of 60% by non-rebreather mask

The change-of-shift report has just been completed on the medical-surgical unit. Which client will the oncoming nurse plan to assess first?

Client with cystic fibrosis (CF) who has an elevated temperature and a respiratory rate of 38 breaths/min.

When caring for a client who had a lobectomy the nurse notes small bubbles in the water seal chamber of the disposable chest drainage device during coughing. Which of these reflects the appropriate action by the nurse?

Document the finding in the medical record.

The nurse in the clinic is following up on diagnostic testing for a client recently diagnosed with metastatic lung cancer and back pain. Which of these findings does the nurse expect to uncover?

Hypercalcemia

The nurse is providing education to a client with chronic bronchitis who has a new prescription for a mucolytic. Which of these will the nurse teach the client about the purpose of the medication?

Mucolytics thin secretions, allowing for easier expectoration.

The nurse is educating the client with COPD who requires home oxygen therapy for discharge. Which of these teaching points takes the highest priority?

Removing combustion hazards present in the home

The nurse is preparing to administer oxygen to a client with chronic obstructive pulmonary disease (COPD) who has hypoxemia and hypercarbia. The nurse recognizes that a positive outcome to therapy has been achieved by which of these findings?

The oxygen saturation is between 88% and 90%.

A client has just been admitted to the intensive care unit after having a left lower lobectomy via video-assisted thorascopic surgery. Which of these prescriptions will the nurse implement first?

Titrate oxygen flow rate to keep O2 saturation at or greater than 93%.

A client with COPD calls the pulmonary clinic reporting the last 24 hours the peak flow meter readings have been in the yellow range. Which of these interventions by the nurse is appropriate at this time?

Use your prescription for rescue medication and retest yourself.

When caring for the client with chronic bronchitis, which of these interventions will assist the client in mobilizing secretions?

consume at least 2 liters of fluid daily