Chronic Obstructive Pulmonary Disorder
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, 90%
Which drugs are used to treat COPD? (Select all that apply.) a. Anticholinergic medications b. Glucocorticoids c. Leukotriene modifiers d. Long-acting beta2 agonists e. Monoclonal antibodies
ANS: A, B, D Anticholinergic drugs, glucocorticoids, and LABAs are used to treat COPD. Leukotriene modifiers and monoclonal antibodies are used only to treat asthma.
A nurse evaluates the results of a spirometry test to help confirm a diagnosis of obstructive lung disease. Which one of the following results indicates an initial early stage of COPD? (FEV1 refers to forced expired volume in 1 second.) FEV1 > 80% FEV1 = 70% FEV1 = 50% FEV1 = 30%
FEVI> 80%
A home health nurse visits a client with chronic obstructive pulmonary disease who requires oxygen. Which statement by the client indicates the need for additional teaching about home oxygen use? "I lubricate my lips and nose with K-Y jelly." "I make sure my oxygen mask is on tightly so it won't fall off while I nap." "I have a 'no smoking' sign posted at my front door to remind guests not to smoke." "I clean my mask with water after every meal."
I make sure my oxygen mask is on tightly so it won't fall off while I nap
Which of the following medications are classified as leukotriene modifiers (inhibitors)? Select all that apply. Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo) Ipratropium HFA (Atrovent) Tiotropium (Spiriva)
Montelukast (Singulair) Zafirlukast (Accolate) Zileuton (Zyflo)
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? Cromolyn sodium Theo-Dur Serevent Proventil
Proventil
Which of the following occupy space in the thorax, but do not contribute to ventilation? Bullae Alveoli Lung parenchyma Mast cells
bullae
The nurse is reviewing first-line pharmacotherapy for smoking abstinence with a client diagnosed with COPD. The nurse correctly includes which medications? Select all that apply. Nicotine gum Clonidine Bupropion SR Varenicline
nicotine gum bupropion SR
A client is receiving theophylline for long-term control and prevention of asthma symptoms. Client education related to this medication will include the importance of blood tests to monitor serum concentrations. taking the medication at least 1 hour prior to meals. monitoring liver function studies as prescribed. development of hyperkalemia.
the importance of blood tests to monitor serum concentrations
A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply. Thick mucus Swelling of bronchial membranes Destruction of the alveolar wall Airway remodeling
thick mucus airway remodeling swelling of bronchial membranes
A nurse should establish which outcomes on the care plan for a patient taking oral terbutaline? A. Absence of tachycardia B. No reports of chest pain C. Less irritation of gum tissue D. Decrease in bronchospasm E. No jaundice or dark urine
A, B, D Terbutaline is an oral beta2 agonist. It promotes bronchodilation through activation of beta2 receptors in the lung, which relieves bronchospasm. It also stimulates the beta receptors of the heart and can result in tachycardia and chest pain if dosing is excessive. Irritated mucosal tissue of the gums, jaundice, and dark urine are not adverse effects of the medication.
Which instruction should be included in the teaching for a patient for whom fluticasone propionate [Flovent] MDI has been ordered? A. "Gargle after using your inhaler." B. "Take the medication immediately at the onset of an attack." C. "Take your albuterol first, followed by the Flovent 5 minutes later." D. "Make sure you monitor your fingerstick blood glucose level each morning."
A. "Gargle after using your inhaler." Patients should be taught to gargle after using inhaled glucocorticoids, such as fluticasone propionate, to minimize dysphonia and oropharyngeal candidiasis. The medication is not used to abort an acute attack. Short-acting bronchodilators, such as albuterol, should be administered 5 minutes before inhaled glucocorticoids to enhance delivery to the bronchial tree. Oral glucocorticoids pose a risk of hyperglycemia.
The nurse is caring for several patients who receive a beta agonist inhalation treatment for asthma. After treatments are administered, it would be of greatest priority to reassess the patient who also has a history of which condition? A. Heart failure (HF) B. Deep vein thrombosis (DVT) C. Gastroesophageal reflux (GERD) D. Rheumatoid arthritis (RA)
A. Heart failure (HF)
Which are advantages of a dry-powder inhaler (DPI) over a metered-dose inhaler (MDI)? A. More of the drug is delivered to the lungs and less to the oropharynx. B. Use of a spacer is not necessary. C. Less propellant is needed to deliver the medication. D. Less hand-lung coordination is required. E. DPIs pose no environmental risk.
A. More of the drug is delivered to the lungs and less to the oropharynx. B. Use of a spacer is not necessary. D. Less hand-lung coordination is required. E. DPIs pose no environmental risk. DPIs deliver more drug to the lungs (20% of the total released, compared to 10% for MDIs). Spacers are not necessary with DPIs; they are recommended for use with MDIs to increase the delivery of drug to the lungs rather than the oropharyngeal mucosa. DPIs do not require the hand-lung coordination needed with MDIs. DPIs present no environmental hazard, because no propellant is required for delivery.
A patient with severe, chronic COPD uses an inhaled LABA/glucocorticoid but continues to have frequent exacerbations of symptoms. The nurse will contact the provider to discuss: a. adding roflumilast [Daliresp] once daily. b. changing to oral theophylline twice daily. c. prescribing oral steroids once daily. d. Using an ipratropium/albuterol combination twice daily.
ANS: A For patients with chronic, severe COPD, the risk of exacerbations may be reduced with roflumilast. Theophylline is used only when other bronchodilators are not effective. Oral steroids are not indicated for this use. Ipratropium is used to treat bronchospasm in COPD.
A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? a. A long-acting inhaled beta2 agonist b. An oral beta2 agonist c. A short-acting beta2 agonist d. An intravenous methylxanthine
ANS: A LABAs are preferred over SABAs for COPD. Oral beta2 agonists are not first-line therapy. Although theophylline, a methylxanthine, was once standard therapy in COPD, it is no longer recommended. It is used only if beta2 agonists are not available.
A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast [Singulair] to the child's regimen. Which statement by the child's parent indicates understanding of this medication? a. "I may notice mood changes in my child." b. "I should give this medication twice daily." c. "I will give my child one 4-mg chewable tablet daily." d. "This drug can alleviate symptoms during an acute attack."
ANS: A Montelukast is given as an adjunct to inhaled glucocorticoids to help prevent inflammation. Some patients have reported mood changes when taking this drug, so parents should be warned of this effect. The medication is given once daily. The dose for a 7-year-old child is 5 mg daily. The drug does not treat symptoms of an acute attack.
A patient has just received a prescription for fluticasone/salmeterol [Advair Diskus]. What will the nurse include as part of the teaching for this patient about the use of this device? a. "You do not need good hand-lung coordination to use this device." b. "You will begin to inhale before activating the device." c. "You will need to use a spacer to help control the medication." d. "You will take 2 inhalations twice daily."
ANS: A The Advair Diskus is a dry powder inhaler and is activated by inhalation; therefore, hand-lung coordination is not required. There is no need for a spacer. Patients who use the Diskus take 1 inhalation twice daily.
A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What will the nurse do? a. Ask whether the patient is rinsing the mouth after each dose. b. Request an order for an antifungal medication. c. Suggest that the patient be tested for a bronchial infection. d. Tell the patient to discontinue use of the glucocorticoid.
ANS: A The most common side effects of inhaled glucocorticoids are oropharyngeal candidiasis and dysphonia. To minimize these, patients should be advised to gargle after each administration. Antifungal medications are used after a fungal infection has been diagnosed. Hoarseness is not a sign of a bronchial infection. There is no need to discontinue the glucocorticoid.
What are the results of using glucocorticoid drugs to treat asthma? (Select all that apply.) a. Reduced bronchial hyperreactivity b. Reduced edema of the airway c. Reduced number of bronchial beta2 receptors d. Increased responsiveness to beta2-adrenergic agonists e. Increased synthesis of inflammatory mediators
ANS: A, B, D Glucocorticoids act by reducing bronchial hyperreactivity and airway edema and increasing airway responsiveness to beta2-adrenergic agonists. They do not reduce the number of beta2-adrenergic agonist receptors. They help reduce the synthesis of inflammatory mediators.
A patient who takes oral theophylline [Theochron] twice daily for chronic stable asthma develops an infection and will take ciprofloxacin. The nurse will contact the provider to discuss: a. changing to a different antibiotic. b. reducing the theophylline dose. c. giving theophylline once daily. d. switching from theophylline to a LABA.
ANS: B Fluoroquinolone antibiotics increase theophylline levels, so the dose of theophylline may need to be reduced to prevent theophylline toxicity. Changing antibiotics, giving the theophylline once daily, and changing to a LABA are not indicated.
A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen? a. "I should use the glucocorticoid as needed when symptoms flare." b. "I will need to use the beta2-adrenergic agonist drug daily." c. "The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators." d. "The glucocorticoid is used as prophylaxis to prevent exacerbations."
ANS: D Inhaled glucocorticoids are used daily to prevent acute attacks. They are not used PRN. The beta2-adrenergic agonist drugs should not be used daily; they are used to treat symptoms as needed. They do not suppress mediators of inflammation.
A nurse is teaching a group of nursing students about the different formulations of beta2-adrenergic agonist medications. Which statement by a student indicates understanding of the teaching? a. "Beta2-adrenergic agonists provide quick relief via any formulation." b. "Long-acting beta2 agonists may be used alone to prevent attacks." c. "Short-acting beta2 agonists are usually given by nebulizer." d. "Oral beta2 agonists are not useful for short-term treatment."
ANS: D Oral beta2 agonists are used only for long-term control. All formulations vary; long-acting beta2 agonists (LABAs) and oral preparations are used for long-term control, whereas short-acting beta2 agonists (SABAs) are useful for acute episodes. LABAs are used in conjunction with inhaled glucocorticoids to prevent attacks. SABAs may be given by MDI or nebulizer and usually are given by MDI.
A patient with COPD is prescribed tiotropium [Spiriva]. After the initial dose, the patient reports only mild relief within 30 minutes. What will the nurse tell the patient? a. "You may have another dose in 4 hours." b. "You may need to take two inhalations instead of one." c. "You should have peak effects in about 6 hours." d. "You should see improved effects within the next week."
ANS: D Tiotropium shows therapeutic effects in about 30 minutes, with improved bronchodilation occurring with subsequent doses, up to 8 days. The medication is given once daily, with inhalation of one capsule. Peak effects occur in 3 hours.
A patient with asthma comes to a clinic for treatment of an asthma exacerbation. The patient's medication history lists an inhaled glucocorticoid, montelukast [Singulair], and a SABA as needed via MDI. The nurse assesses the patient and notes a respiratory rate of 18 breaths per minute, a heart rate of 96 beats per minute, and an oxygen saturation of 95%. The nurse auscultates mild expiratory wheezes and equal breath sounds bilaterally. What will the nurse do? a. Contact the provider to request a systemic glucocorticoid. b. Contact the provider to suggest using a long-acting beta2 agonist. c. Evaluate the need for teaching about MDI use. d. Question the patient about how much albuterol has been used.
ANS: D To determine the next course of action, it is important to assess the drugs given before these symptoms were observed. Patients who continue to wheeze after using a SABA need systemic glucocorticoids and nebulized albuterol. If a SABA has not been used, that will be the first intervention. LABAs are not used for exacerbations. If a patient reports using a SABA without good results, evaluating the MDI technique may be warranted.
A client is being admitted to the medical-surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations? Albuterol Cromolyn sodium Levalbuterol HFA Ipratropium
Cromolyn sodium
Which statement should the nurse include in the teaching for a patient who is to be started on zileuton [Zyflo]? A. "Use your zileuton [Zyflo] inhaler every 12 hours." B. "Have your blood drawn once a month for the next 3 months so that your liver function can be checked." C. "Take the zileuton [Zyflo] 2 hours before eating breakfast each day." D. "Take an extra dose of zileuton [Zyflo] if you have an asthmatic attack."
B. "Have your blood drawn once a month for the next 3 months so that your liver function can be checked." Zileuton can injure the liver, as evidenced by increased plasma levels of alanine aminotransferase (ALT). Therefore, ALT should be monitored once a month for 3 months, then every 2 to 3 months for the remainder of the first year, and periodically thereafter. Zileuton is an oral, not an inhaled, medication that is rapidly absorbed with or without food. The timing of administration with regard to meals is insignificant. Zileuton is used for asthma prophylaxis and cannot be used to abort an attack.
A nurse is teaching a patient about montelukast [Singulair]. Which statement by the patient would indicate that the nurse's teaching was effective? A. "I'll take a dose as soon as I feel short of breath and start to cough." B. "While taking this medicine, I may be able to reduce my steroid medication." C. "This is the priority medication for preventing exercise-induced asthma symptoms." D. "If I have nosebleeds or excessive bruising, I'll stop the medication immediately."
B. "While taking this medicine, I may be able to reduce my steroid medication." Montelukast is an antileukotriene agent. Combining montelukast with an inhaled glucocorticoid medication can improve asthma symptoms and thus may allow a reduction in the glucocorticoid dosage. The effects of montelukast develop slowly, so it cannot be used as a quick-relief agent. Short-acting beta2 agonists are preferred for exercise-induced asthma. Montelukast does not affect coagulation, so bleeding and bruising do not occur.
The nurse would question the prescriber if which drug regimen was ordered for an asthmatic patient? select all that apply A. Albuterol inhaler, two puffs before exercise, not exceeding eight puffs in 24hours for a 14 year old patient. B. Albuterol (AccuNeb) followed by budesonide suspension (Pulmicort Respules) via ultrasonic nebulizer for a 6 year old patient. C. Budesonide suspension (Pulmicort Respules) followed by albuterol (AccuNeb) via jet nebulizer with a mask for a 4 year old patient. D. Salmeterol (Serevent), 2 puffs every 12 hours for a 20 year old patient. E. Salmeterol (Serevent Diskus), one inhalation and budesonide (Pulmicort Flexhaler) every 12 hours for 40 year old patient.
B. Albuterol (AccuNeb) followed by budesonide suspension (Pulmicort Respules) via ultrasonic nebulizer for a 6 year old patient. C. Budesonide suspension (Pulmicort Respules) followed by albuterol (AccuNeb) via jet nebulizer with a mask for a 4 year old patient. D. Salmeterol (Serevent), 2 puffs every 12 hours for a 20 year old patient.
A patient who takes cromolyn for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness? A. It should be used infrequently because of systemic adverse effects. B. One 10-mg tablet should be taken at least 2 hours before exercising. C. It should be administered by inhalation 15 minutes before anticipated exertion. D. It should be used as a quick-relief agent if exercise triggers asthma symptoms.
C. It should be administered by inhalation 15 minutes before anticipated exertion. Cromolyn suppresses inflammation through inhibition of histamine release. It must be administered at least 15 minutes before exertion to prevent exercise-induced bronchospasm. It is administered by inhalation only. It is not a bronchodilator and cannot abort an ongoing attack. It is one of the safest antiasthma medications and has no systemic adverse effects.
The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply. Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries Left ventricular hypertrophy
Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction? "Because I am prescribed a corticosteroid-containing MDI, I will rinse my mouth with water after use." "I can't use a spacer or holding chamber with the MDI." "I will take a slow, deep breath in after pushing down on the MDI." "I will shake the MDI container before I use it."
I can't use a spacer or holding chamber with the MDI
Asthma is cause by which type of response? IgE-mediated IgA-mediated IgD-mediated IgM-mediated
IgE-mediated
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 Intravenous methylprednisolone (Solu-Medrol) 120 mg Ipratropium bromide (Alupent) by metered-dose inhaler Vancomycin 1 gram intravenously over 1 hour
Oxygen through nasal cannula at 2 L/minute
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
The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as
atelectasis
Which type of chest configuration is typical of a client with COPD?
barrel chest
A 42 year old asthmatic patient who is prescribed budesonide (Pulmicort Turbuhaler) and formoterol (Foradil Aerolizer), 2 puffs every 12 hours, is admitted for a surgery. Which information would be of greatest priority for the nurse to share with the anesthesiologist? A. This patient experiences an asthma attack whenever exposed to tobacco smoke. B. The patient has degenerative joint disease (osteoarthritis) of the knees. C. The patient uses albuterol (Proventil) MDI, two puffs every 4hours as needed. D. The patient was recently changed from long term oral methylprednisolone to inhaled beclomethasone
The patient was recently changed from long term oral methylprednisolone to inhaled beclomethasone
Which statement describes emphysema? A disease of the airways characterized by destruction of the walls of overdistended alveoli A disease that results in reversible airflow obstruction, a common clinical outcome Presence of cough and sputum production for at least a combined total of 2 to 3 months in each of two consecutive years Chronic dilatation of a bronchus or bronchi
a disease of the airways characterized by the destruction of the walls of overdistended alveoli
Which of the following is accurate regarding status asthmaticus? A severe asthma episode that is refractory to initial therapy Patients have a productive cough. Usually occurs with warning Usually does not progress to severe obstruction
a severe asthma episode that is refractory to initial therapy
A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. The nurse knows this would probably be Atrovent Albuterol Foradil Isuprel
albuterol
In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply. Albuterol is a bronchodilator. Dexamethasone is an antibiotic. Cotrimoxazole is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.
albuterol is a bronchodilator ciprofloxacin is an antibiotic prednisone is a corticosteroid
Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? Select all that apply. Tobacco smoke Occupational dust Air pollution Infection Second-hand smoke
all of the above
Which is the strongest predisposing factor for asthma?
allergy
After reviewing the pharmacological treatment for pulmonary diseases, the nursing student knows that bronchodilators relieve bronchospasm in three ways. Choose the correct three of the following options. Alter smooth muscle tone Reduce airway obstruction Decrease alveolar ventilation Increase oxygen distribution
alter smooth muscle tone reduce airway obstruction increase oxygen distribution
A client with chronic obstructive pulmonary disease (COPD) is admitted to an acute care facility because of an acute respiratory infection. When assessing the client's respiratory status, which finding should the nurse anticipate? An inspiratory-expiratory (I:E) ratio of 2:1 A transverse chest diameter twice that of the anteroposterior diameter An oxygen saturation of 99% A respiratory rate of 12 breaths/minute
an inspiratory-expiratory (I:E) ration of 2:!
A client with asthma is being treated with albuterol (Proventil). Which of the findings from the client's history would indicate to the nurse the need to administer this drug with caution? Raynaud's disease Peptic ulcer disease Bronchospasm Angina
angina
Which statement is true about both lung transplant and bullectomy? Both procedures cure COPD. Both procedures treat end-stage emphysema. Both procedures treat patients with bullous emphysema. Both procedures improve the overall quality of life of a client with COPD.
both procedures improve the overall quality of life of a client with COPD
Which symptoms are considered primary symptoms of COPD? Cough Sputum production Dyspnea upon exertion Weight gain
cough
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 Jugular vein distention Ascites
decreased airflow compromised gas exchange wheezes
Which of the following is a symptom diagnostic of emphysema? Dyspnea Copious sputum production Normal elastic recoil The occurrence of cor pulmonale
dyspnea
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? Asthma Bronchiectasis Cystic fibrosis Emphysema
emphysema
A client has chronic obstructive pulmonary disease (COPD) and is exhibiting shallow respirations of 32 breaths per minute, despite receiving nasal oxygen at 2 L/minute. To improve the client's shortness of breath, the nurse encourages the client to Take deep breaths Exhale slowly Perform upper chest breaths Increase the flow of oxygen
exhale slowly
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 Occupational exposure Passive smoking Ambient air pollution
exposure to tobacco smoke
A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?
high protein
The nursing student recalls that the underlying pathophysiology of chronic obstructive pulmonary disease (COPD) includes the following components: (Select all that apply.) Inflamed airways obstruct airflow. Mucus secretions block airways. Overinflated alveoli impair gas exchange. Dry airways obstruct airflow.
inflamed airways obstruct air flow mucus secretions block airways overinflated alveoli impair gas exchange
The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan? Restricting oral intake to 1,000 mL/day Providing the client a low-sodium diet Performing chest physiotherapy as ordered Discussing palliative care and end-of-life issues with the client
performing chest physiotherapy as ordered
The client is prescribed albuterol (Ventolin) 2 puffs as a metered-dose inhaler. The nurse evaluates client learning as satisfactory when the client Positions the inhaler 1 to 2 inches away from his open mouth Carefully holds the inhaler upright without shaking it Holds the breath for 5 seconds after administering the medication Immediately repeats the second puff after the first puff
positions the inhaler 1-2 inches away from open mouth
A client has been classified as status asthmaticus. The nurse understands that this client will likely initially exhibit symptoms of: Respiratory alkalosis Metabolic alkalosis Respiratory acidosis Metabolic acidosis
respiratory alkalosis
The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). What does the nurse anticipate observing for the blood gas results related to hyperventilation for this patient? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis
respiratory alkalosis
A pneumothorax is a possible complication of COPD. Symptoms will depend on the suddenness of the attack and the size of the air leak. The most common, immediate symptom that should be assessed is: Sharp, stabbing chest pain Dyspnea A dry, hacking cough Tachycardia
sharp, stabbing chest pain
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? Chest pain during respiration Sputum and a productive cough Fever, chills, and diaphoresis Tachypnea and tachycardia
sputum and productive cough
cystic fibrosis (CF) is diagnosed by clinical signs and symptoms in addition to which test? Pulmonary function studies Sweat chloride concentration Arterial blood gases Lumbar puncture
sweat chloride production
A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client's condition is worsening when he: sits in tripod position. has a pulse oximetry reading of 93%. uses the sternocleidomastoid muscles. wants the head of the bed raised to a 90-degree level.
uses the sternocleidomastoid muscles
