347 ch 23 prep u management of pts w/ chest & lower resp tract disorder
ARDS occurs when oxygen tension (PaO2) falls to less than _______ mmHg (hypoxemia) and carbon dioxide tension (PaCO2) rises to greater than _____mmHg
PaO2. 60 PaC02. 50
what dietary recommendation should a nurse provide a client with lung abscess
a diet rich in protein
on auscultation, which findings suggest a right pneumothorax
absence of breath sounds in the right thorax
client who has just had a triple -lumen catheter placed in his right subclavian vein complains of chest pain and SOB, his bp is decreased from baseline and on auscultation of his chest, the nurse notes unequal breath sounds. a chest x-ray is immediately ordered by the physician. what diagnosis should the nurse suspect
pneumothorax
a nurse recognizes that a client with tuberculosis needs further teaching when the client states
the people I have contact with a work should be checked regularly
nurse is educating a patient who will be started on an antituberculosis medication regimen. the patient asks the nurse "how long will i have to be on these medications" what should the nurse tell the patient
6-12 months
the nurse is caring for a 2 year old near drowning victim monitors for what possible complications?
acute respiratory distress syndrome
which vitamin us usually administered with isoniazid (INH) to prevent INH- associated peripheral neuropathy?
vitamin B 6
a client is admitted to the health care facility with acute TB. what intervention should the nurse include in the clients care plan?
wearing a disposable particulate respirator that fits snugly around the face
nurse is preparing dietary recommendations for a client with a lung abscess. which statement would be included in the plan of care?
you must consume a diet rich in protein, such as chicken, fish, and beans
a client admitted with multiple traumatic injuries receives massive fluid resuscitation. later the physician suspects that the client has aspirated stomach contents. the nurse knows that this client is a highest risk of
acute respiratory distress syndrome (ARDS)
the nurse knows that a sputum culture is necessary to identify the causative organism for acute tracheobronchitis. what causative fungi organism would the nurse suspect
aspergillus
which statement indicated a client understanding about the purified protein derivative (PPD) test for tuberculosis ?
because I had a previous reaction to the test, this time I need to get a chest x-ray
a client with pulmonary hypertension has a positive vasoreactivity test. what medication does the nurse anticipate administering to this client?
calcium channel blockers
during discharge teaching a nurse is instructing a client about pneumonia. the client demonstrates his understanding of relapse when he states that he must
continue to take antibiotics for the entire 10 days
the nurse is auscultating the patients lung sounds to determine the presence of pulmonary edema. what adventitious lung sounds are significant for pulmonary edema?
crackles in the lung bases
which intervention does a nurse implement for a client with empyema
deep breathing exercises
a recent immigrant is diagnosed with pulmonary tuberculosis (TB). which intervention is the most important for the nurse to implement with this client?
developing a list of people with whom the client has had contact
nurse is assessing a client who comes to the clinic fro care. which finding in this client suggest bacterial pneumonia?
dyspnea and wheezing
nurse is assessing a patient who has been admitted with possible ARDS. which finding would be evidence for a diagnosis of cardiogenic pulmonary edema rather that ARDS
elevated B type natriuretic peptide (BNP) levels
which intervention does a nurse implement for clients with empyema?
encourage breathing exercise
a client hospitalized with pneumonia has thick, tenacious secretions. which intervention should the nurse include when planning care ?
encourage increased fluid intake
a patient arrive in the ED after being involved in a motor vehicle accident . the nurse observes paradoxical chest movement when removing the patient's shirt. what does the nurse know that this finding indicated
flail chest
nurse has instructed a client on how to perform pursed lip breathing. the nurse recognizes the purpose of this type of breathing is to accomplish which results
improve oxygen transport, induce a slow, deep breathing pattern, and assist the client to control breathing
client who underwent surgery 12 hours ago has difficulty breathing. he has petechiae over his chest and complain of acute pain. which action should the nurse take first?
initiate oxygen therapy
nurse is assessing a clients potential for pulmonary emboli. what finding indicated possible deep vein thrombosis
localized calf tenderness
nurse assess ABG results for a patient in acute respiratory failure (ARRF). which results are consistent with this disorder
pH 7.28 PaO2 50mmHg
a client is brought to the ED following a motor vehicle accident. which of the following nursing assessments is significant in diagnosing this client with frail chest?
paradoxical chest movement
a physician stated to the nurse that the client has fluid in the pleural space and will need a thoracentesis. the nurse expects the physician to document this fluid as
pleural effusion
the nurse is assessing a client who, after an extensive surgical procedure is at risk for developing acut respiratory distress syndrome (ARDS) the nurse assesses for which most common early sign of ARDS
rapid onset of severe dyspnea
you are caring for a client status post lung resection. when assessing your client you find that the bubbling in the water seal chamber for the chest tube is more than you expected. what should you check when bubbling in the water seal chamber us excessive?
see if there are leaks in the system
patient comes to the clinic with fever, cough, and chest discomfort. the nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. what does the nurse know is the most common organism that causes community-acquires pneumonia?
streptococcus pneumonia
a nurse admits a new client with acute respiratory failure. what are the clinical findings of a client with acute respiratory failure?
sudden onset of lung impairment in a client who had normal lung function
a client is being discharged following a pelvic surgery. what would be included in the patient care instructions to prevent the development of a pulmonary embolus
tense and relax muscles in the lower extremities