Management of patients with chronic pulmonary disease
The classification of Stage III of COPD is defined as
severe COPD
A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?
Lung sounds
What is histamine, a mediator that supports the inflammatory process in asthma, secreted by? Eosiniphils Lymphocytes Mast cells Neutrophils
Mast cells
The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan?
Performing chest physiotherapy as ordered
A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect?
Respiratory rate of 22 breaths/minute
A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:
diminished or absent breath sounds on the affected side.
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes
implementing measures to clear pulmonary secretions.
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?
"I can't use a spacer or holding chamber with the MDI."
A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?
"Weigh yourself daily and report a gain of 2 lb in 1 day."
The classification of Stage II of COPD is defined as
moderate COPD.
A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary?
"I do not need to rinse my mouth with this type of inhaler."
Asthma is cause by which type of response?
IgE-mediated
The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.
60 mm Hg; 90%
Which statement describes emphysema?
A disease of the airways characterized by destruction of the walls of overdistended alveoli
A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis?
Anxiety
The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as
Atelectasis
You are caring for a client with obstructive pulmonary disease. Your nursing care includes diagnoses, outcomes, and interventions for what?
Atelectasis
Which statement is true about both lung transplant and bullectomy?
Both procedures improve the overall quality of life of a client with COPD.
A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse?
Collects sputum for culture and sensitivity
A home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?
Decreased oxygen requirements
A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder?
Emphysema
The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client Exhales hard and fast with a single blow Inhales deeply and holds the breath Records in a diary the number achieved after one breath Sits in a straight-back chair and leans forward
Exhales hard and fast with a single blow
Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)?
Exposure to tobacco smoke
In which grade of COPD is the forced expiratory volume (FEV) less than 30%? I II III IV
IV
A client diagnosed with asthma is preparing for discharge. The nurse is educating the client on the proper use of a peak flow meter. The nurse instructs the client to complete which action?
If coughing occurs during the procedure, repeat it.
A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply. Inflamed airways that obstruct airflow Mucus secretions that block airways Overinflated alveoli that impair gas exchange Dry airways that obstruct airflow Decreased numbers of goblet cells
Inflamed airways that obstruct airflow Mucus secretions that block airways Overinflated alveoli that impair gas exchange
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:
Oxygen therapy through a non-rebreather mask
A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments? Oxygen through nasal cannula at 2 L/minute Intravenous methylprednisolone (Solu-Medrol) 120 mg Ipratropium bromide (Alupent) by metered-dose inhaler Vancomycin 1 gram intravenously over 1 hour
Oxygen through nasal cannula at 2 L/minute
The client is prescribed albuterol 2 puffs as a metered-dose inhaler. Which action by the client demonstrates understanding of administration for this medication?
Positions the inhaler 2 finger widths away from the lips
The nurse is educating a patient with asthma about preventative measures to avoid having an asthma attack. What does the nurse inform the patient is a priority intervention to prevent an asthma attack?
Preparing a written action plan
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?
Providing sufficient oxygen to improve oxygenation
Which of the following is not a primary symptom of COPD?
Weight gain
Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.
Wheezes Decreased airflow Compromised gas exchange
A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client?
albuterol
Which is the strongest predisposing factor for asthma?
allergy
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?
Respiratory acidosis
Which is the most important risk factor for development of COPD?
cigarette smoking
A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?
Respiratory acidosis
