Chapter 24: Management of Patients With Chronic Pulmonary Disease

Which of the following exposures accounts for most of the risk factors of COPD? A. Exposure to tobacco smoke B. Occupational exposure C. Passive smoking D. Ambient air pollution

A. Exposure to tobacco smoke

A nurse notes that the FEV1/ FVC ratio is less than 70% and the FEV1 is 65% for a patient with COPD. What stage should the nurse document the patient is in? A. I B. II C. III D. IV

II.

A client with COPD is recovering from a MI. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for: A. Pleural Effusion B. Pulmonary Edema C. Atelactasis D. Oxygen Toxicity

Atelactasis In a client with COPD, an ineffective cough impedes secretion removal. This in turn causes mucus plugging--> localized airway obstruction- atelactasis PE usually results from left sided heart failure

A client experiencing an asthmatic attack is prescribed methylprednisolone (Solu-medrol) intravenously. The nurse: A. Aspirates for blood return B. Assess fasting glucose levels C. Encourages the client to decrease caloric intake due to increased appetite D. Informs the client to limit fluid intake due to fluid retention

B. Assess glucose levels Adverse effects include abnormalities in glucose metabolism. Methyl increases appetite and fluid retention but the client will not decrease caloric or fluid intake.

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment? A. Providing sufficient oxygen to improve oxygenation B. Avoiding the use of oxygen to decrease the hypoxic drive C. Monitoring the pulse oximetry to assess need for early intervention when PCO2 levels rise D. Increasing pH

Providing sufficient oxygen

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Respiratory acidosis

A client being seen in the emergency department has labored respirations. Auscultation reveals inspiratory and expiratory wheezes. Oxygen saturation is 86%. The client was nonresponsive to an albuterol (Ventolin) inhaler and intravenous methylprednisolone (Solu-Medrol). The nurse administers the following prescribed treatment first: A. Oxygen therapy through a non-rebreather mask B. Intravenous magnesium sulfate C. Normal saline 0.9% at 100 mL/hr intravenously D. Oral fluid of at least 2500 mL/day

A. Oxygen therapy through a non-rebreather mask

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education? A. The patient should take the medication with meals since it may cause nausea. B. The patient should take the medication separately without other medications. C. The patient should take the medication an hour before meals or 2 hours after a meal. D. The patient should take the medication with a small amount of liquid.

C. The patient should take the medication an hour before or 2 hours after a meal

As status asthmaticus worsens, the nurse would expect which acid-base imbalance? A. Respiratory alkalosis B. Metabolic alkalosis C. Respiratory acidosis D. Metabolic acidosis

Respiratory Acidosis

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