Med Surg 1 Chapter 30 Part 2

The primary health care provider prescribes macitentan to an adult patient with pulmonary arterial hypertension. What instructions should the nurse give the patient?

"Take the medicine with a glass of water." Macitentan should be taken with a glass of water to ensure effective absorption. The tablet should not be chewed, broken, or crushed because that alters the absorption and therapeutic action of the medication.

Which treatment is effective to remove thick mucus and sputum for a patient with a chronic cough who is undergoing treatment for lung cancer?

Mucolytics Mucolytics dissolve thick mucus and sputum formed in the lungs and helps ease removal. Thoracentesis is the removal of excess fluid though suction by a large needle or catheter placed into the intrapleural space. Antibiotic therapy treats bacterial infections. Radiation therapy is used to treat hemoptysis, which is obstruction of the bronchi and great veins.

While caring for a patient with cystic fibrosis, the nurse suspects that the patient has acquired an infection. Which laboratory finding supports the nurse's suspicion?

11,000 white blood cells per microliter Cystic fibrosis is a genetic disorder that lethally impairs lung function. Cystic fibrosis associated with infection results in an elevated white blood cell count. The normal range of white blood cells is 4,500-10,000 per microliter. Therefore, 11,000 white blood cells per microliter indicates infection in the patient. White blood cell counts of 5,000, 7,000, and 9,000 per microliter are within the normal range.

Which people are considered at higher risk for inheriting pulmonary arterial hypertension (PAH)?

A person whose sibling is affected Pulmonary arterial hypertension (PAH) is a common complication of lung disorders. In some people it occurs due to gene mutation and unknown environmental factors. Autosomal dominant inheretence is frequently seen in this type of disease with reduced penetrance. The presence of the gene in a sibiling indicates increased risk of inheritence. A person who has both parents unaffected has a reduced risk of inheritence. Presence of the gene in the second degree relatives decreases the risk of inheritence. The presence of the disease in the grandparents reduces the risk of inheritence.

What is indicated if the laboratory report of a patient with suspected lung cancer shows purulent and copious sputum?

Necrosis Copious, purulent sputum indicates production of pus-containing sputum in large quantities. In lung cancer, the presence of necrosis leads to purulent and copious sputum. Bronchitis occurs with obstruction in lung cancer. Hemoptysis reflects bloody sputum due to lung cancer. Pneumonitis is indicated by chills, fever, and cough.

Which ectopic hormone is involved in Cushing syndrome and may cause small cell lung cancer?

Adrenocorticotropic hormone Overproduction of ectopic adrenocorticotropic hormone causes Cushing syndrome, which may lead to small cell lung cancer. An abnormal production of antidiuretic hormone causes syndrome of inappropriate antidiuretic hormone (SIADH). An abnormal production of parathyroid hormone causes hypercalcemia. Abnormal production of follicle-stimulating hormone causes gynecomastia.

When assessing a patient suspected of having lung cancer, the nurse feels increased vibrations on the chest wall. What could be the reason for the vibrations?

Airspaces of the lung replaced with tumor An increased vibration on the chest wall, or fremitus, indicates that the airspaces of the lungs are being replaced by the tumor or fluid. When a tumor is present near the tracheal area, it results in the displacement of the trachea. In lung cancer, purulent and copious sputum indicates necrosis of the tissue. Pleura are the two membranes that surround and protect the lungs. Inflammation of pleura is indicated by chest pain and an elevated diaphragm.

The nurse is assessing a patient with suspected lung cancer. While auscultating lung sounds, the nurse hears an increased loudness of the patient's voice. What does this finding indicate?

An increased density of the lung tissue During assessment of the breath sounds, an increased sound intensity of the patient's voice indicates an increased density of the lung tissue. This occurs due to tumor compression. During the assessment of breathing sounds, the presence of inflammation is indicated by pleural friction rub. A complete obstruction of the airway by a tumor or fluid is indicated by decreased breathing sounds. A partial obstruction of the airflow in the passages narrowed by tumors or fluids is indicated by wheezing sounds.

Which patient condition may be treated by oxygen therapy?

Anxiety Humidified oxygen may be prescribed to relieve dyspnea and anxiety. Edema cannot be treated by humidified oxygen. Empyema is a complication in which there is a purulent material present in the pleural space. Bronchospasms are treated by bronchodilators.

The nurse begins assessing a patient with a chest tube following a right-sided lobectomy and observes 2 cm of water in chamber two of the three-chamber chest tube drainage system and also notes that the water has stopped bubbling. What is the correct action by the nurse?

Auscultate the lung sounds and assess respiratory status The water level in chamber two is adequate. Bubbling stops when all of the air has been evacuated from the pleural space, so this is most likely a normal finding. The nurse should continue the assessment. It is not necessary to add water. The absence of bubbling is not a sign of tube obstruction. Notifying the Rapid Response Team is not indicated.

After reviewing the laboratory and diagnostic reports of a patient with cystic fibrosis, the nurse suspects that interventional radiology is needed in the patient. Which finding supports the nurse's suspicion?

Bronchiole bleeding A patient with cystic fibrosis develops bronchiole bleeding in the later stages of life. Interventional radiology is needed to embolize the bleeding of the arterial branches. Ivacaftor is needed for a patient with genetic mutations. Co-trimoxazole is needed for a patient with bacterial infection. Vitamin supplements are needed for a patient with vitamin deficiency.

Which home-care therapy is most important for a patient with cystic fibrosis (CF) to help prevent exacerbations of the disease?

Chest physiotherapy Patients with CF have thick, tenacious secretions, which are difficult to clear, and serve as a reservoir for infections. Daily chest physiotherapy is central to ongoing management of CF. Nutritional management and diabetes prevention are necessary but not the most important. Prophylactic antibiotics are used later in the disease course after repeated infections and colonization with bacteria.

A patient scheduled for a lobectomy to treat stage II cancer is anxious about the surgical procedure. Which preoperative teaching points may help decrease the patient's anxiety about the surgery? Select all that apply.

Chest tube and drainage system Probable location for surgical incision Shoulder exercises to increase comfort Teaching the patient about the chest tube drainage system will prepare him or her to deal with the situation once the surgery is over. Teaching about the probable location of the surgery will help decrease the patient's anxiety. Teaching about shoulder exercises will help the patient deal with discomfort caused by the placement of the chest tube and the drainage system. Teaching the patient about dietary management, risks associated of postoperative infection, and necessary interventions will not decrease his or her anxiety.

What is the greatest risk factor for lung cancer?

Cigarette Smoking Cigarette smoking is the number-one risk factor for lung cancer and COPD. Alcohol can cause some cancers and liver disease and can increase risky behaviors, but it is not a major cause of lung cancer. Although asbestos is carcinogenic and some components of marijuana are carcinogenic, neither is the major risk factor for lung cancer.

A patient admitted with pulmonary arterial hypertension experiences dyspnea and light-headedness when transferred from the wheelchair to the bed. Which level of severity does the nurse document the patient as having?

Class III Patients who experience dyspnea, chest pain, fatigue, and light-headedness while engaged in less-than-ordinary physical activity are categorized as class III in severity. Class I is characterized by no symptoms with moderate physical activity. Class II is characterized by symptoms associated with mild to moderate physical activity. Class IV is characterized by symptoms with any physical activity along with manifestations of right-sided heart failure.

A patient reports breathing difficulty and fatigue at rest. After assessing the patient and reviewing the diagnostic reports, the nurse finds dependent edema, engorged neck veins, and enlarged liver. Which class of primary pulmonary arterial hypertension does the nurse categorize this patient in?

Class IV The manifestations of class IV primary pulmonary arterial hypertension are presence of dyspnea or breathing difficulties and fatigue at rest. Right-sided heart failure is apparent, which includes dependent edema, engorged neck veins, and enlarged liver. The manifestation of class I primary pulmonary arterial hypertension is pulmonary hypertension diagnosed by pulmonary function tests and right-sided cardiac catheterization. The manifestations of class II primary pulmonary arterial hypertension are dyspnea and fatigue during mild activity. The manifestations of class III primary pulmonary arterial hypertension are dyspnea and fatigue during less-than-ordinary activities.

A patient who has frequent respiratory infections and chronic chest congestion has a sweat chloride level of 85 mEq/L. The nurse suspects this laboratory value indicates which disease process?

Cystic fibrosis A sweat chloride level between 60 and 200 mEq/L is positive for cystic fibrosis (CF) because the defect in chloride movement that is characteristic of CF prevents absorption of sodium chloride in the sweat glands and increased chloride in a patient's sweat. This does not occur with asthma, bronchitis, or emphysema.

A patient reports a cough and limited exercise tolerance. Which disease does the nurse suspect in this patient when the diagnostic reports indicate the presence of Burkholderia cepacia?

Cystic fibrosis Cystic fibrosis is a genetic disease that causes cough and limited exercise tolerance. It spreads by Burkholderia cepacia. Therefore, the presence of Burkholderia cepacia indicates cystic fibrosis. Sarcoidosis is not caused by Burkholderia cepacia; it is an autoimmune response, which is characterized by an increased number of normally protective T-lymphocytes, and damaged alveolar cells. Idiopathic pulmonary fibrosis and pulmonary arterial hypertension are not diagnosed by the presence of Burkholderia cepacia.

Which statement should the nurse use to describe cystic fibrosis when teaching a patient about the disease?

Cystic fibrosis is associated with the formation of thick mucus. Cystic fibrosis is associated with the formation of thick mucus because of poor chloride transport. Cystic fibrosis affects the lungs, pancreas, liver, salivary glands, and testes. Cystic fibrosis is present in a patient from birth. Cystic fibrosis is an autosomal recessive disorder.

What is a late manifestation of lung cancer?

Dysphagia The patient with lung cancer can have inflammation of the food pipe that results in dysphagia. Lung cancer patients suffer from nausea and vomiting that can cause anorexia, so polyphagia is not likely to develop. Tachypnea is not likely, although the patient develops dyspnea due to decreased functional ability of the lungs. The patient with lung cancer is likely to have weight loss.

Which complication is least likely to occur in a patient who underwent photodynamic therapy (PDT) in the airways?

Dyspnea PDT may be used to remove small bronchial tumors. Dyspnea is not a complication associated with PDT. Dyspnea may be a complication after thoracentesis. When PDT is performed for airways, the patient usually requires a stay in the hospital because sloughing of tissue can block the airways. The patient may be at a risk of developing hemoptysis, fistula formation, and bronchial hemorrhage.

What is the primary factor responsible for the clinical manifestations of cystic fibrosis?

Mechanical obstruction by increased viscosity of secretions Cystic fibrosis (CF) is caused by blocked chloride transport across the cell membrane, which results in the production of thick mucus secretions that can cause obstruction. It is not caused by hyperactivity of the sweat glands. The mucosal wall of the intestines does not atrophy with CF; however, there is a large volume of undigested food in the bowel from the lack of pancreatic enzymes present in the GI tract. CF pathology results in hyperactivity, not hypoactivity, of the autonomic nervous system.

Which is an example of a primary lung cancer prevention measure that the nurse can implement?

Educating about the risks associated with smoking Primary prevention measures are those that work to prevent diseases from occurring. Teaching about the risks of smoking can help reduce the risk of lung cancer. The other measures are examples of secondary and tertiary prevention because they involve actions that occur once the disease is present.

After reviewing the genetic analysis reports of a patient with cystic fibrosis, the primary health care provider prescribes ivacaftor. Which finding will the nurse expect in the patient during follow-up visits?

Elevated liver enzymes A patient with cystic fibrosis who is having mutations in one of the CFTR genes, such as G551D, will be prescribed ivacaftor. The most common adverse effect of ivacaftor is the elevation of liver enzymes. Bone fracture, sensory hearing loss, and gastroesophageal reflux disease are problems that occur with cystic fibrosis over time.

A patient with small-cell lung cancer (SCLC) has gynecomastia. This is most likely due to paraneoplastic syndrome caused by the tumor cells secreting which hormone?

Follicle-stimulating hormone SCLC tumor cells can secrete an excess of specific hormones, with each resulting in a different paraneoplastic syndrome. Gynecomastia is the result of SCLC tumor cells secreting an excess of follicle-stimulating hormone (FSH). The excess secretion of antidiuretic hormone causes syndrome of inappropriate antidiuretic hormone (SIADH). Increased secretion of parathyroid hormone causes hypercalcemia, and the oversecretion of adrenocorticotropic hormone causes an excess of cortisol, which results in Cushing's syndrome.

The primary health care provider prescribes endothelin-receptor agonist to a patient with primary pulmonary arterial hypertension. Which effects in the patient does the nurse observe due to endothelin-receptor agonist? Select all that apply

Hypotension General vessel dilation Decrease in pulmonary arterial pressure Endothelin-receptor agonists induce hypotension because of general vessel dilation. They decrease pulmonary arterial pressure by causing blood vessel relaxation. Endothelin-receptor agonist has no effect on clot formation.

A patient reporting dyspnea and fatigue is diagnosed with pulmonary arterial hypertension. Which pathological manifestations will the nurse expect in the patient? Select all that apply.

Hypoxemia Right side heart failure Blood vessel constriction The pathological problems associated with pulmonary arterial hypertension are poor perfusion and gas exchange that lead to hypoxemia. Right side heart failure is observed due to continuous workload of pumping against the high pulmonary pressures. Due to the increased vascular resistance, blood vessels get constricted. Pulmonary blood pressure is increased due to blood vessel constriction which causes increased vascular resistance in the lung.

What conditions in a patient with cystic fibrosis (CF) indicate acute exacerbation? Select all that apply.

Increased chest congestion Decreased oxygen saturation Increased carbon dioxide retention When cystic fibrosis (CF) proceeds to the end stage, chest congestion increases, oxygen saturation levels decrease, and carbon dioxide retention increases. In a normal stage of CF, there is limited activity tolerance and an increased production of sputum. But decreased sputum production and increased activity level are not seen in patients with CF.

Which clinical manifestation would the nurse observe in a patient with cystic fibrosis associated with infection?

Intercostal retractions Intercostal retractions are observed in a patient with cystic fibrosis associated with infection. Tachypnea, weight loss, and tachycardia are the manifestations associated with infection in cystic fibrosis.

. How does chest physiotherapy benefit a patient with cystic fibrosis (CF) through relieving symptoms?

It creates mini-coughs to dislodge the mucus from the lungs. Chest physiotherapy uses chest percussion, chest vibration, and dependent drainage to loosen secretions and promote drainage. This therapy encourages mini-coughs that dislodge the mucus from the bronchial walls and increase mobilization. This mucus moves toward the central airways where it can be removed by coughing or suctioning. Vascular resistance in the lungs is seen in patients with pulmonary arterial hypertension (PAH). Drug therapy helps in the management of excess mucus production in patients with cystic fibrosis (CF). Bronchodilator drugs help in the relaxation of the smooth muscles in patients with asthma.

Which statement is true about primary pulmonary arterial hypertension?

It is also known as idiopathic pulmonary hypertension. Primary pulmonary arterial hypertension is also known as idiopathic pulmonary hypertension because its cause is unknown. Medications such as fenfluramine and phentermine increase the risk for primary pulmonary arterial hypertension. Primary pulmonary arterial hypertension is a rare disorder. It occurs in the absence of other lung disorders

Which statement is true about primary pulmonary arterial hypertension?

It is also known as idiopathic pulmonary hypertension. Primary pulmonary arterial hypertension is also known as idiopathic pulmonary hypertension because its cause is unknown. Medications such as fenfluramine and phentermine increase the risk for primary pulmonary arterial hypertension. Primary pulmonary arterial hypertension is a rare disorder. It occurs in the absence of other lung disorders.

A patient who is receiving radiation therapy for lung cancer is experiencing esophagitis. The nurse consults with a registered dietitian who recommends which element as part of the patient's diet?

Liquid nutrition supplements Patients with esophagitis caused by radiation therapy will have difficulty meeting nutritional needs, and the nurse should recommend liquid nutrition supplements to boost calories. Cool, clear liquids or warm liquids are not calorie-dense and will not improve nutritional status. Enteral feedings are not recommended; a nasogastric tube will cause irritation of the esophagus.

Which condition presents symptoms of hoarseness, change in respiratory pattern, persistent cough, blood-streaked sputum, dyspnea, clubbing of the fingers, and fever?

Lung Cancer Hoarseness, change in respiratory pattern, persistent cough, blood-streaked sputum, hemoptysis, dyspnea, clubbing of the fingers, and fever are associated with lung cancer. Asthma patients generally have irregular episodes of dyspnea, cough, wheezing, and increased mucus production. Cystic fibrosis is associated with thick and sticky mucus resulting in airflow obstruction. Pulmonary arterial hypertension is characterized by dyspnea and fatigue due to increasing vascular resistance in lungs.

Which pulmonary diseases are caused by cigarette smoking? Select all that apply.

Lung cancer Chronic bronchitis Lung cancer can occur because of repeated exposure to inhaled substances during smoking. Chronic bronchitis is caused by exposure to irritants such as cigarette smoke. Cystic fibrosis is caused by poor chloride transport. Drugs such asphentermine increase the risk for pulmonary arterial hypertension. Bronchiolitis obliterans organizing pneumonia is not caused by cigarette smoking.

Which is the leading cause of cancer-related deaths in North America?

Lung cancer Lung cancer is the leading cause of cancer-related deaths worldwide. In North America the main cause of cancer-related deaths is lung cancer, when compared to colon cancer, breast cancer, and prostate cancer combined. The American Cancer Society estimates that more than 228,000 new cases of lung cancer are diagnosed each year and that more than 160,000 deaths occur each year due to it.

Which action should be avoided in the chest tube drainage system while caring for a patient with lung cancer?

Manipulating the chest tube The chest tube should not be manipulated because manipulation can create up to 400 cm of negative water pressure, which can damage lung tissue. The chest tube should be kept as straight as possible for proper drainage. The wet suction control system should maintain the water level at -20 cm. The drainage system should be kept lower than the patient's chest level because gravity helps in proper drainage.

Which statement is true about surgical procedures for a patient with cystic fibrosis?

Patients remain in the intensive care unit for a few days after transplantation. Patients remain in the intensive care unit for several days after transplantation to monitor for any symptoms of transplant rejection. Patients having a double-lung transplant need a bypass. Patients having a single-lung transplant do not need a bypass because the single lung can deliver the oxygen. Patients undergoing a lung transplant will receive tissue from both a live donor and a cadaver.

What is a possible reason for the development of bronchopleural fistula in a patient with lung cancer?

Pneumonectomy Pneumonectomy is a surgical procedure that involves removal of a lung, which may create complications such as bronchopleural fistula. Drug therapy, thoracentesis, and radiation therapy are unassociated with development of bronchopleural fistula.

A patient with cystic fibrosis has undergone pancreatic transplantation. During the follow-up visit, the nurse finds symptoms of transplant rejection in the patient. Which cause does the nurse suspect for this condition?

Poor intestinal absorption of anti-rejection drugs Transplant rejections are common in a patient with cystic fibrosis because of poor intestinal absorption of anti-rejection drugs. Immunosuppressants are beneficial for transplant patients because these drugs help suppress the mechanism of immunity; therefore, these drugs do not cause transplant rejections. The transplantation is possible only when the donor and the recipient have the same blood type. The pancreatic tissue can be obtained from a living donor.

What is the most efficient diagnostic test to determine metastasis in lung cancer?

Positron emission tomography Positron emission tomography is the most effective way to locate the spread of lung cancer; it provides more details of cellular level metabolic changes. Computerized tomography examinations are used to identify lesions more clearly and to guide the biopsy procedures. Electromagnetic radiation uses X-rays to primarily identify lung lesions. Magnetic resonance imaging helps the primary health care provider identify the spread of cancer to other parts of the body.

What respiratory system-related assessment findings does the nurse use to guide the care of a patient with lung cancer? Select all that apply.

Presence of pain with breathing, dyspnea, and wheezing Respiratory rate, depth, and inspiration/exhalation balance Interference with activities of daily living, work, recreation, and family activities Respiratory assessments should include the presence of chest or pleuritic pain that may interfere with, and alter, breathing. Prolonged exhalation alternating with periods of shallow breathing may be present with obstruction. Patients experiencing hypoxemia may have rapid, shallow respirations. Changes in respiratory rate and depth may also accompany infections. The amount of interference with activity should guide the nurse in planning for what the patient will be able to tolerate and determining appropriate pacing of activity with rest periods. The presence of confusion or personality changes may be indicative of brain metastasis or potentially inadequate oxygenation but is not a primary respiratory assessment. Similarly, the presence of anxiety, guilt, and shame for smoking is a psychosocial, not respiratory, assessment.

What is the role of the second chamber in a chest tube drainage system?

Prevents air from re-entering the patient's pleural space The second chamber of the chest tube drainage system prevents air from re-entering the patient's pleural space. The third chamber controls the suction of the system. The first chamber collects the fluid draining from the patient. The bubbles are formed in the second chamber, which indicates the drainage status. These bubbles are not collected by the second chamber

What is the role of the second chamber in a chest tube drainage system?

Prevents air from re-entering the patient's pleural space The second chamber of the chest tube drainage system prevents air from re-entering the patient's pleural space. The third chamber controls the suction of the system. The first chamber collects the fluid draining from the patient. The bubbles are formed in the second chamber, which indicates the drainage status. These bubbles are not collected by the second chamber.

Which complication does the nurse expect when finding puffiness or crackling at the site of chest tube insertion in a patient with lung cancer?

Subcutaneous emphysema Subcutaneous emphysema occurs when gas or air is present in the layer under the skin. During the management of chest tube drainage systems, the tube insertion site should be checked to assess the skin condition. If puffiness or crackling is found on palpation, it indicates subcutaneous emphysema. Infection is indicated by redness or purulent drainage. Bone metastasis is indicated by pain. Tracheal deviation indicates the presence of pressure caused by a disease in the trachea

Why might a patient's laboratory report show dilution of serum electrolytes?

Production of antidiuretic hormone from a different tissue Ectopic insulin, antidiuretic hormone, parathyroid hormone, and adrenocorticotropic hormone are ectopic hormones. When the antidiuretic hormone is produced from a tissue not associated with the production of the hormone, it leads to dilution of serum electrolytes. When the production of ectopic insulin occurs from a different tissue, it results in hypoglycemia. The production of parathyroid hormone from a different tissue results in hypercalcemia. Cushing's syndrome is caused by adrenocorticotropic hormone when the hormone is produced from a different tissue.

Which diagnostic test is used to determine the diffusion capacity in a patient with pulmonary arterial hypertension?

Pulmonary function tests Pulmonary function tests are used to determine the diffusion capacity in a patient with pulmonary arterial hypertension. Computed tomography is used to create detailed pictures or scans of the areas inside the body. Ventilation-perfusion scans are used to measure breathing and circulation. Right-sided heart catheterization is used to measure pulmonary pressure.

What is an effective treatment for a patient with lung cancer whose clinical and laboratory reports show hemoptysis, obstruction of the bronchi, and superior vena cava syndrome?

Radiation therapy Radiation therapy helps cure hemoptysis, obstruction of bronchi, and superior vena cava syndromes. Drug therapy is effective for reducing inflammation and edema of lungs. Thoracentesis is performed for the removal of pleural fluid and prevents its formation. Photodynamic therapy is used to remove bronchial tumors that can be easily visualized by bronchoscopy

Which complication does the nurse suspect in a patient with cystic fibrosis?

Respiratory failure Respiratory failure is a complication of cystic fibrosis. Cystic fibrosis damages the lung tissue very badly until the lungs no longer work, leading to respiratory failure. Cystic fibrosis may cause diabetes mellitus, thus leading to hyperglycemia. Cystic fibrosis does not inhibit the thyroxin secretion and, therefore, does not result in hypothyroidism. Cystic fibrosis does not stimulate overproduction of melanin so it does not result in hyperpigmentation.

Which physiological change in cystic fibrosis (CF) may cause airway obstruction?

Secretion of thick and sticky mucus In cystic fibrosis (CF), blocked chloride transportation causes the formation of sticky and thick mucus which has less water content. This sticky mucus obstructs the airway, leading to difficulty in breathing. The constriction of smooth muscle causes bronchospasm. Mucus secretion with excess water content does not cause any obstruction in the airway. Excess secretion of the protease enzyme causes breaking of the elastin in the alveoli; this leads to chronic obstructive pulmonary diseases.

Which patient teaching point could conceivably prevent the majority of all lung cancers?

Smoking cessation Cigarette smoking is responsible for 85% of all lung cancer deaths and is regarded as the major risk factor; it increases the risk for smokers as well as those exposed to passive smoke. Although more information is being gained about genes and lung cancer risks, knowledge does not yet enable prevention of the disease. Use of proper masks and respirators when exposed to carcinogenic inhalants would decrease the risk of lung cancer for a smaller population, but not to the extent of smoking cessation. In addition, smoking actually increases the risk of lung cancer in individuals exposed to other occupational carcinogenic inhalants. The use of radiologic screening of smokers has improved the early detection of disease, but it is not a preventive measure.

Which statement is true regarding the stationary chest tube drainage system?

The tubes from the patient are connected to the first chamber There are three chambers used in the stationary chest tube drainage system. The first chamber is the drainage collecting chamber. Regulation of suction activity is performed by the third chamber. The second chamber is the water seal, which prevents air from moving back up the tubing system, and into the patient's chest.

What is the underlying physiological problem in cystic fibrosis (CF)?

Thick, sticky mucus The basis for altered physiology in CF is blocked chloride transport in cell membranes resulting in the formation of mucus that has little water content and is thick and sticky. This mucus causes problems in all organs, including the lungs, pancreas, liver, salivary glands, and testes. Airway hyperreactivity is the underlying cause of asthma symptoms. Interstitial changes in the lungs and reduced pulmonary air flow occur late in the disease as the result of chronic, thick mucus.

What would be the most effective treatment for a patient with lung cancer who is diagnosed with pleural effusion?

Thoracentesis Thoracentesis involves fluid removal by suction, and it is very effective for curing pleural effusion. Drug therapy, pneumonectomy, and radiation therapy are unassociated with the treatment of pleural effusion. Drug therapy with bronchodilators and corticosteroids is used for the treatment of bronchospasm. Pneumonectomy is the surgical removal of lung. Radiation therapy helps cure obstruction of the bronchi and great veins (superior vena cava syndrome).

What is the rationale behind prescribing digoxin and diuretics to a patient with pulmonary arterial hypertension?

To improve cardiac function The heart of a patient with pulmonary arterial hypertension undergoes hypertrophy and decreased cardiac function. Therefore, digoxin and diuretics are prescribed to improve cardiac function. Calcium channel blockers are prescribed to dilate blood vessels. Oxygen therapy is used to reduce dyspnea and to ensure proper oxygen supply. Digoxin and diuretics do not cure pulmonary arterial hypertension completely.

The primary health care provider prescribes warfarin to a patient with pulmonary arterial hypertension. What does the nurse think is the reason behind this prescription?

To prevent clot formation in lungs Warfarin is an anticoagulant that prevents clot formation in the lungs. Warfarin has no effect on blood flow to the lungs. It reduces pulmonary pressure and leads to decreased vascular resistance in the lungs.

What is a possible reason for the physician to instruct the nurse to administer erlotinib to a patient?

To treat non-small cell lung cancer Erlotinib is provided for the treatment of non-small cell lung cancer by inhibiting the epidermal growth factor receptor. Alopecia, or hair loss; neutropenia, or abnormal decrease in the number of neutrophils; and thrombocytopenia, or an abnormal decrease in the number of platelets, are the side effects of chemotherapy.

What should a nurse advise women of childbearing age who are getting treated with macitentan for pulmonary arterial hypertension (PAH)?

Use at least two types of contraceptive methods during treatment Macitentan, an endothelin receptor antagonist drug, is used to treat pulmonary arterial hypertension (PAH). Its use is contraindicated in women as it causes birth defects if taken during pregnancy. Therefore, women should be advised to use two types of contraceptive methods to avoid pregnancy during the treatment period. The medication does not increase the risk of infection, so preventive measures are not needed. Trying to change the form of the tablet by chewing, breaking, or crushing it may change its mechanism of action. Using the drug without abrupt stopping is general advice for all medications.

What should a nurse advise women of childbearing age who are getting treated with macitentan for pulmonary arterial hypertension (PAH)?

Use at least two types of contraceptive methods during treatment. Macitentan, an endothelin receptor antagonist drug, is used to treat pulmonary arterial hypertension (PAH). Its use is contraindicated in women as it causes birth defects if taken during pregnancy. Therefore, women should be advised to use two types of contraceptive methods to avoid pregnancy during the treatment period. The medication does not increase the risk of infection, so preventive measures are not needed. Trying to change the form of the tablet by chewing, breaking, or crushing it may change its mechanism of action. Using the drug without abrupt stopping is general advice for all medications.

Which interventions may help patients with cystic fibrosis (CF) avoid infections?

Washing hands regularly and avoiding contact with body fluids A patient with cystic fibrosis (CF) has a risk of severe bacterial infection which is caused by Burkholderia cepacia. Because the infection is antibiotic-resistant, care should be taken to prevent it by washing hands regularly. The patient should avoid direct contact with bodily fluids such as saliva and sputum which will decrease the chance of contacting the infection. Maintaining appropriate weight through nutritional management helps to avoid malnutrition. Maintening pulmonary hygiene to clear mucus secretions from the airway is the general management technique used in CF patients. Taking bi-level positive airway pressure as a daily therapy to avoid mechanical ventilation may be part of the treatment for patients with advanced disease.