Chapter 27 Non infectious Lower Respiratory Problems

A nurse is teaching a client how to perform pursed-lip breathing. Which instructions would the nurse include in this teaching? (Select all that apply.) "Open your mouth and breathe deeply." "Use your abdominal muscles to squeeze air out of your lungs." "Breath out slowly without puffing your cheeks." "Focus on inhaling and holding your breath as long as you can." "Exhale at least twice the amount of time it took to breathe in." "Lie on your back with your knees bent."

"Use your abdominal muscles to squeeze air out of your lungs." "Breath out slowly without puffing your cheeks." "Exhale at least twice the amount of time it took to breathe in."

he nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur? 1. "Take as deep a breath as possible." 2. "Stand up (unless you have a physical disability)." 3. "Place the meter in your mouth, and close your lips around the mouthpiece." 4. "Make sure the device reads zero or is at base level." 5. "Blow out as hard and as fast as possible for 1 to 2 seconds." 6. "Write down the value obtained." 7. "Repeat the process two additional times, and record the highest number in your chart." a. 4, 2, 1, 3, 5, 6, 7. 3, 4, 1, 2, 5, 7, 6. C.2, 1, 3, 4, 5, 6, 7 d. 1, 3, 2, 5, 6, 7, 4

4, 2, 1, 3, 5, 6, 7

A nurse cares for a client who had a chest tube placed 6 hours ago and refuses to take deep breaths because of the pain. Which action should the nurse take? a. Ambulate the client in the hallway to promote deep breathing. b. Auscultate the client's anterior and posterior lung fields. c. Encourage the client to take shallow breaths to help with the pain. d. Administer pain medication and encourage the client to take deep breaths.

Administer pain medication and encourage the client to take deep breaths.

A nurse is assessing a client with lung cancer. What nonpulmonary signs and symptoms would the nurse be aware of? (Select all that apply.) Gynecomastia in male patients Frequent shaking and sweating relieved by eating Positive Chvostek and Trousseau signs "Moon" face and "buffalo" hump Expectorating purulent sputum General Edema

Gynecomastia in male patients Frequent shaking and sweating relieved by eating "Moon" face and "buffalo" hump General Edema

The nurse is preparing to teach a community group about warning signs of lung cancer. What information does the nurse include? (Select all that apply.) Over 10-pack-year history of smoking Persistent coughing Rusty or blood-tinged sputum Dyspnea Hoarseness Fatigue

Persistent coughing Rusty or blood-tinged sputum Dyspnea Hoarseness

A nurse assesses a client who has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? (Select all that apply.) a. Production of pink sputum b. Tracheal deviation c. Pain at insertion site d. Sudden onset of shortness of breath e. Drainage greater than 70 mL/hrf. Disconnection at Y site

Tracheal deviation Sudden onset of shortness of breath Drainage greater than 70 mL/hr Disconnection at Y site

A nurse assesses a client who has a chest tube. For which manifestations should the nurse immediately intervene? (Select all that apply.) a. Production of pink sputum b. Tracheal deviation c. Sudden onset of shortness of breath d. Pain at insertion sitee. Drainage of 75 mL/hr

Tracheal deviation Sudden onset of shortness of breath

A nurse cares for a client who has a chest tube. When would this client be at highest risk for developing a pneumothorax? a. When the insertion site becomes red and warm to the touch b. When the tube drainage decreases and becomes sanguineous c. When the client experiences pain at the insertion sited. When the tube becomes disconnected from the drainage system

When the tube becomes disconnected from the drainage system

A nurse assesses a client who is prescribed fluticasone (Flovent) and notes oral lesions. Which action should the nurse take? a. Encourage oral rinsing after fluticasone administration. b. Obtain an oral specimen for culture and sensitivity. c. Start the client on a broad-spectrum antibiotic. d. Document the finding as a known side effect.

a. Encourage oral rinsing after fluticasone administration.

A nurse cares for a client who is prescribed an intravenous prostacyclin agent. Which actions should the nurse take to ensure the client's safety while on this medication? (Select all that apply. )a. Keep an intravenous line dedicated strictly to the infusion. b. Teach the client that this medication increases pulmonary pressures. c. Ensure that there is always a backup drug cassette available. d. Start a large-bore peripheral intravenous line. e. Use strict aseptic technique when using the drug delivery system.

a. Keep an intravenous line dedicated strictly to the infusion. c. Ensure that there is always a backup drug cassette available. e. Use strict aseptic technique when using the drug delivery system.

While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action should the nurse take first? a. Assess for drainage from the site. b. Cover the insertion site with sterile gauze . c. Contact the provider and obtain a suture kit. d. Reinsert the tube using sterile technique.

b. Cover the insertion site with sterile gauze.

After teaching a client how to perform diaphragmatic breathing, the nurse assesses the client's understanding. Which action demonstrates that the client correctly understands the teaching? a. The client lays on his or her side with his or her knees bent. b. The client places his or her hands on his or her abdomen .c. The client lays in a prone position with his or her legs straight. d. The client places his or her hands above his or her head.

b. The client places his or her hands on his or her abdomen.

The nurse is caring for a client with lung cancer who states, "I don't want any pain medication because I am afraid I'll become addicted." How should the nurse respond? a. "I will ask the provider to change your medication to a drug that is less potent." b. "Would you like me to use music therapy to distract you from your pain?" c. "It is unlikely you will become addicted when taking medicine for pain." d. "Would you like me to give you acetaminophen (Tylenol) instead?"

c. "It is unlikely you will become addicted when taking medicine for pain."

A nurse cares for a client who is infected with Burkholderia cepacia. Which action should the nurse take first when admitting this client to a pulmonary care unit? a. Instruct the client to wash his or her hands after contact with other people. b. Implement Droplet Precautions and don a surgical mask. c. Keep the client isolated from other clients with cystic fibrosis. d. Obtain blood, sputum, and urine culture specimens.

c. Keep the client isolated from other clients with cystic fibrosis.

A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection should the nurse provide for this client? a. Spaghetti with meat sauce, ice cream b. Chicken soup, grilled cheese sandwich c. Omelet, soft whole wheat bread d. Pasta salad, custard, orange juice

c. Omelet, soft whole wheat bread

A nurse cares for a client who has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment? a. Strip the tubing to minimize clot formation and ensure patency .b. Secure tubing junctions with clamps to prevent accidental disconnections. c. Connect the chest tube to wall suction at the level prescribed by the provider. d. Keep padded clamps at the bedside for use if the drainage system is interrupted.

d. Keep padded clamps at the bedside for use if the drainage system is interrupted.