nur 111 - edge - COPD
Which medications are prescribed for patients with chronic obstructive pulmonary disorder (COPD) because of relaxation of the smooth muscles of the respiratory tract? Select all that apply. -Anticholinergics Rationale: Anticholinergics relax and enlarge the airways in the lungs, making breathing easier. -Glucocorticoids Rationale: Glucocorticoids decrease inflammation. -Short acting beta2-agonists Rationale: Beta2-agonists - short acting (SABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction. -Antibiotics Rationale: Antibiotics are for secondary bacterial infections. -Long acting beta2-agonists Rationale: Beta2-agonists - long acting (LABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction.
-Anticholinergics Rationale: Anticholinergics relax and enlarge the airways in the lungs, making breathing easier. -Short acting beta2-agonists Rationale: Beta2-agonists - short acting (SABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction. -Long acting beta2-agonists Rationale: Beta2-agonists - long acting (LABA) relax smooth muscles of the airway by stimulating beta-adrenergic receptors, resulting in antagonism to bronchoconstriction. Test Taking Tips: Consider each answer option and "true or false."
A patient with COPD reporting chest tightness arrives at the hospital. On assessment, the nurse notes wheezing, cough, elevated blood pressure, and pulse rate. The primary health-care provider prescribes corticosteroids. Which is the most likely outcome of the prescribed therapy? -Increases the hydration of airway Rationale: Inhalation of hypertonic saline increases the hydration of airway in cystic fibrosis. -Decreases the inflammation of airway Rationale: Inhalation of corticosteroids decreases the inflammation and swelling of airway. -Aids in bronchial smooth muscle relaxation Rationale: Beta-2 adrenergic agonists aid in bronchial smooth muscle relaxation. -Aids in muscle relaxation around the alveoli Rationale: Anticholinergics aid in muscle relaxation around the alveoli.
-Decreases the inflammation of airway Rationale: Inhalation of corticosteroids decreases the inflammation and swelling of airway. Test Taking Tips: Focus on the purpose of corticosteroids, regardless of the presenting symptoms.
A patient with a severe cough and decreased appetite arrives at the hospital. On assessment, the nurse finds the anterior-posterior diameter as 2:2. After reviewing the assessment findings, what action should the nurse take first? -Apply 100% nonrebreather mask. Rationale: High flow oxygen will cause the client to retain CO2 and become acidotic. O2 should be applied at 2 L/nasal cannula. -Request a bronchodilator small volume nebulizer (SVN) treatment. Rationale: This will help to open the airways and improve oxygenation. -Encourage pursed-lip breathing. Rationale: This will slow the ventilation and allow for air to better escape from the alveoli. Draw arterial blood gasses. Rationale: This is good to determine the acid-base balance, but pursed-lip breathing is less invasive and should be performed first.
-Encourage pursed-lip breathing. Rationale: This will slow the ventilation and allow for air to better escape from the alveoli. Test Taking Tips: Least - invasive first.
Which is true regarding emphysema? -It is caused by inflammation of bronchioles. Rationale: Emphysema causes inflammation of alveoli. -It is associated with blood-tinged sputum. Rationale: Lung cancer is associated with blood-tinged sputum. -It is associated with chronic respiratory acidosis. Rationale: Emphysema is associated with chronic respiratory acidosis. -It is associated with chronic dilation of bronchioles. Rationale: Chronic dilation is associated with bronchiectasis.
-It is associated with chronic respiratory acidosis. Rationale: Emphysema is associated with chronic respiratory acidosis. Test Taking Tips: Look for opposites in the answer's choices.
A patient with end-stage chronic obstructive pulmonary disorder (COPD) develops sudden dyspnea and chest pain. A spontaneous pneumothorax is suspected. What is the nurse's priority action? -Maintain oxygenation. Rationale: Treatment priorities include supplemental oxygenation. -Place chest tube. Rationale: Treatment priorities include supplemental oxygenation and chest tube placement to remove air from the pleural space to allow re-expansion of the affected lung. Oxygen is the higher priority until the tube can be placed. -Intubate. Rationale: Intubation would occur if the patient is compromised. Oxygenation would be first. -Provide pain medicine. Rationale: This is important, but not the priority.
-Maintain oxygenation. Rationale: Treatment priorities include supplemental oxygenation. Test Taking Tips: Consider what can be done quickly.
A patient with exacerbation of chronic obstructive pulmonary disorder (COPD) has a respiratory rate of 28 breaths per minute. What action should the nurse take? -Increase the oxygen. Rationale: Tachypnea is often from an acid-base disturbance in COPD and not hypoxia. -Provide comfortable positioning. Rationale: This is the priority. The tachypnea is needed to prevent an acid-base disturbance. -Provide a sedative. Rationale: Hypoventilation is discouraged in this situation since the tachypnea is maintaining the acid-base concerns. -Encourage slowing of the breathing. Rationale: Hypoventilation should be discouraged.
-Provide comfortable positioning. Rationale: This is the priority. The tachypnea is needed to prevent an acid-base disturbance. Test Taking Tips :In this case tachypnea is a positive finding.
A patient with chronic obstructive pulmonary disorder (COPD) is reporting shortness of breath. On assessment, the nurse finds a pulse rate of 115 beats/min, a blood pressure of 152/94 mm Hg, a temperature of 101°F, and a respiratory rate of 28. Which respiratory test is priority? -Perform incentive spirometry Rationale: Spirometry is the test that measures airflow and lung volumes. This evaluates the function of the respiratory system. It is not the priority. -Pulse oximetry Rationale: Pulse oximetry is a noninvasive method of measuring oxygen saturation. This is important information to gather. -Obtain a forced expiratory volume Rationale: Forced expiratory volume is a major pulmonary function test that measures the amount of air that can be forced out of the lungs after a full inspiration. This is not the priority. -Peak expiratory flow readings Rationale: Peak expiratory flow readings measure the maximum airflow expired during a forced expiration. The patient's peak flow readings are compared with the personal best reading with a reading obtained during an exacerbation or asthma attack. The treatment plan is determined based on these readings.
-Pulse oximetry Rationale: Pulse oximetry is a noninvasive method of measuring oxygen saturation. This is important information to gather. Test Taking Tips: Consider what can be done quickly.
The nurse is evaluating the effectiveness of a small volume nebulizer bronchodilator treatment for a patient with emphysema. Which assessment change indicates an effective outcome of the therapy? Select all that apply. -Pulse oximetry reading goes from 92% to 94%. Rationale: In increase in the pulse oximetry indicates increased oxygenation. -Audible wheezes are diminished. Rationale: Wheezes are a sign on restrictive airway, so a decrease is an encouraging sign. -Heart rate increases from 98 to 110 beats per minute. Rationale: This is a side effect and not a sign of an effective outcome. -The client states "my breathing is the same." Rationale: The patient should have an improvement of their breathing. -Facial complexion is a ruddier color. Rationale: This is a side effect, not an effective outcome.
-Pulse oximetry reading goes from 92% to 94%. Rationale: In increase in the pulse oximetry indicates increased oxygenation. -Audible wheezes are diminished. Rationale: Wheezes are a sign on restrictive airway, so a decrease is an encouraging sign. Test Taking Tips: Consider each answer option and "true or false."
The nurse is caring for a patient with COPD who is on ventilator therapy. Which test is most beneficial to evaluate the patient's response to ventilator therapy? -Spirometry Rationale: Spirometry measures airflow and lung volumes. -Pulse oximetry Rationale: Pulse oximetry (SaO2) is a noninvasive method of measuring oxygen saturation that helps determine the severity of the respiratory distress. -Arterial blood gases (ABG) Rationale: ABG measures oxygenation of the blood, acid-base balance, and the partial pressure of carbon dioxide, and it identifies the patient's response to oxygen and ventilation therapy and medications. -Forced expiratory volume (FEV1) Rationale: FEV1 measures the amount of air that can be forced out of the lungs after a full inspiration in one second. "
Arterial blood gases (ABG) Rationale: ABG measures oxygenation of the blood, acid-base balance, and the partial pressure of carbon dioxide, and it identifies the patient's response to oxygen and ventilation therapy and medications. Test Taking Tips: Look at the stem: "MOST beneficial to evaluate the response.
The nurse is teaching a patient how to use a bronchodilator inhaler for a new diagnosis of emphysema. The patient is having difficulty coordinating the inhalation and exhalation necessary for proper usage. Which option would be best for this patient? Rationale: This is a metered-dose inhaler and requires coordination of inhalation and exhalation for success. Rationale: The use of an aerochamber is ideal in this situation. Rationale: The use of an incentive spirometer would not be helpful for the delivery of medication. Rationale: An endotracheal tube is used for intubation for this case.
Rationale: The use of an aerochamber is ideal in this situation. Test Taking Tips: Look at each image closely. It is the key to success.
