Ch 23: Management of Patients with Chest and Lower Respiratory Tract Disorders

"You should switch to wearing your glasses while taking this medication."

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?

pleural effusion

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

the client has a partial pressure of arterial oxygen (PaO2) value of 90 mm Hg or higher

A client has been hospitalized for treatment of acute bacterial pneumonia. Which outcome indicates an improvement in the client's condition?

paradoxical chest movement

A client is brought to the emergency department following a motor vehicle accident. Which of the following nursing assessments is significant in diagnosing this client with flail chest?

developing a list of people with whom the client has had contact

A recent immigrant is diagnosed with pulmonary tuberculosis (TB). Which intervention is the most important for the nurse to implement with this client?

fibrotic changes in lungs

The occupational nurse is completing routine assessments on the employees where you work. What might be revealed by a chest radiograph for a client with occupational lung diseases?

pneumothorax

A client who has just had a triple-lumen catheter placed in his right subclavian vein complains of chest pain and shortness of breath. His blood pressure 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?

dyspnea

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient?

"I'll stay in isolation for 6 weeks."

A client admitted to the facility for treatment for tuberculosis receives instructions about the disease. Which statement made by the client indicates the need for further instruction?

asbestos

A client who works construction and has been demolishing an older building is diagnosed with pneumoconiosis. This lung inflammation is most likely caused by exposure to:

decreased breath sounds

A client with lung cancer develops pleural effusion. During chest auscultation, which breath sound should the nurse expect to hear?

institute isolation precautions

A client with suspected severe acute respiratory syndrome (SARS) comes to the emergency department. Which physician order should the nurse implement first?

sudden onset of lung impairment in a client who had normal lung function

A nurse admits a new client with acute respiratory failure. What are the clinical findings of a client with acute respiratory failure?

dyspnea and wheezing

A nurse is assessing a client who comes to the clinic for care. Which findings in this client suggest bacterial pneumonia?

cough or change in chronic cough

A nurse is caring for a client who has just been diagnosed with lung cancer. What is a cardinal sign of lung cancer?

ineffective airway clearance

A nurse is caring for a client who was admitted with pneumonia, has a history of falls, and has skin lesions resulting from scratching. The priority nursing diagnosis for this client should be:

impaired gas exchange

A nurse is caring for a client with chest trauma. Which nursing diagnosis takes the highest priority?

encourage breathing exercises

A nurse is caring for a patient diagnosed with empyema. Which of the following interventions does a nurse implement for patients with empyema?

"You must consume a diet rich in protein, such as chicken, fish, and beans."

A nurse is preparing dietary recommendations for a client with a lung abscess. Which statement would be included in the plan of care?

the employee enters the room wearing a gown, gloves and a mask

A nurse observes a new environmental services employee enter the room of a client with severe acute respiratory syndrome. Which action by the employee requires immediate intervention by the nurse?

negative

A nurse reading a chart notes that the client had a Mantoux skin test result with no induration and a 1-mm area of ecchymosis. How does the nurse interpret this result?

flail chest

A patient arrives in the emergency department 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 indicates?

0-4 mm

A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn's disease. What results would the nurse determine is not significant for holding the medication?

blood tinged sputum

A victim has sustained a blunt force trauma to the chest. A pulmonary contusion is suspected. Which of the following clinical manifestations correlate with a moderate pulmonary contusion?

6 to 12 months

After diagnosing a client with pulmonary tuberculosis, the physician tells family members that they must receive isoniazid (INH [Laniazid]) as prophylaxis against tuberculosis. The client's daughter asks the nurse how long the drug must be taken. What is the usual duration of prophylactic isoniazid therapy?

continue to take the antibiotics for the entire 10 days

During discharge teaching, a nurse is instructing a client about pneumonia. The client demonstrates his understanding of relapse when he states that he must:

increased restlessness

In a client with amyotrophic lateral sclerosis (ALS) and respiratory distress, which finding is the earliest sign of reduced oxygenation?

absence of breath sounds in the right thorax

On auscultation, which finding suggests a right pneumothorax?

primary drug resistance

Resistance to a first-line antituberculotic agent in a client who has not received previous treatment is referred to as

acute respiratory distress syndrome

The ICU nurse is caring for a client who was admitted with a diagnosis of smoke inhalation. The nurse knows that this client is at increased risk for which of the following?

chemical irritation

The clinic nurse is caring for a client with acute bronchitis. The client asks what may have caused the infection. What may induce acute bronchitis?

rapid onset of severe dyspnea

The nurse is assessing a client who, after an extensive surgical procedure, is at risk for developing acute respiratory distress syndrome (ARDS). The nurse assesses for which most common early sign of ARDS?

crackles in the lung bases

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

unresponsive arterial hypoxemia

The nurse is caring for a client with suspected ARDS with a pO2 of 53. The client is placed on oxygen via face mask and the PO2 remains the same. What does the nurse recognize as a key characteristic of ARDS?

draining secretions, air, and blood from the thoracic cavity is necessary

What is the reason for chest tubes after thoracic surgery?

turn onto the affected side

Which comfort technique does a nurse teach to a client with pleurisy to assist with splinting the chest wall?

aspiration pneumonia

Which of the following is a potential complication of a low pressure in the endotracheal cuff?

receiving vaccinations

Which should a nurse encourage in clients who are at the risk of pneumococcal and influenza infections?

"Because I had a previous reaction to the test, this time I need to get a chest x-ray."

Which statement indicates a client understands teaching about the purified protein derivative (PPD) test for tuberculosis?

consolidation

Which term refers to lung tissue that has become more solid in nature as a result of a collapse of alveoli or an infectious process?

see if there are leaks in the system

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 tubes is more than you expected. What should you check when bubbling in the water-seal chamber is excessive?

encourage increased fluid intake

You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of care for this client. What nursing interventions would you put into the plan of care for a client with pneumonia?

progressive loss of lung function associated with chronic disease

You are caring for a client with chronic respiratory failure. What are the signs and symptoms of chronic respiratory failure?