Respiratory info from hesi EAQs
A client complains of left-sided chest pain after playing racquetball. The client is hospitalized and diagnosed with left pneumothorax. When assessing the client's left chest area, what does the nurse expect to identify?
Absence of breath sounds on auscultation
Which condition may cause respiratory alkalosis?
Atelectasis
The nurse is caring for a client who is admitted with the diagnosis of mild heart failure. Which type of lung sounds should the nurse expect to hear?
Crackles
In addition to Pneumocystis jiroveci, a client with acquired immunodeficiency syndrome (AIDS) also has an ulcer 4 cm in diameter on the leg. Considering the client's total health status, what is the most critical concern?
Gas exchange
A client is admitted to the hospital with a diagnosis of laryngeal cancer. What is a common early sign of laryngeal cancer for which the nurse should assess this client?
Hoarseness
A nurse gave a client naloxone. To evaluate the effectiveness of the medication, what should the nurse assess for?
Increased respiration
The nurse is caring for a client who has metabolic acidosis as a result of severe dehydration. Which type of respirations does the nurse expect the client to exhibit?
Kussmaul's breathing
Which diagnostic test may be used to distinguish vascular from nonvascular structures?
Magnetic resonance imaging
The parents of a child with spasmodic croup ask why their child is receiving humidified oxygen. What effect of humidified oxygen should the nurse include in the explanation
Minimizes tissue edema
The client has just had a chest tube inserted. How should the nurse monitor for the complication of subcutaneous emphysema?
Palpate around the tube insertion sites for crepitus. (the crackling sound heard when tissues containing gas are palpated)
When assessing a client with pleural effusion, what does the nurse expect to identify?
Reduced or absent breath sounds at the base of the lung
A client with a spontaneous pneumothorax asks, "Why did they put this tube into my chest?" The nurse explains that the purpose of the chest tube is to do what?
Remove air from the pleural space
During chest examination in a healthy client, the nurse percusses and hears a low-pitched sound over the lungs. Which sound should the nurse document in the medical record?
Resonance
A client recovering from abdominal surgery is encouraged to turn from side to side and engage in deep-breathing exercises. What complication is the nurse trying to prevent?
Respiratory acidosis
The nurse is caring for a client who is hyperventilating. The nurse recalls that the client is at risk for what?
Respiratory alkalosis
A client has a chest tube inserted to treat a right hemopneumothorax. In which position should the nurse place the client to facilitate chest drainage?
Right side-lying increases drainage from the pleural space and allows the unaffected lung to expand to the fullest extent.
The nurse finds the respiratory rate is 8 breaths per minute in a client who is on intravenous morphine sulfate. What should the nurse do immediately in this situation?
Stop administering the medication.
a clinical manifestation of respiratory acidosis
Tachycardia
a clinical manifestation of respiratory alkalosis
Tetany
Which is a clinical manifestation of respiratory acidosis?
Tremors
Soft swishing sounds of breathing are heard when the nurse auscultates a client's chest. What term should be used when documenting this assessment?
Vesicular breath sounds
Use sterile gloves when touching the inner cannula.
What must the nurse do when performing tracheostomy care?
Respiratory alkalosis
caused by increased expiration of carbon dioxide, a component of carbonic acid.
pulmonary embolism
is the most common complication of hip surgery because of high vascularity and the release of fat cells from the bone marrow
Metabolic acidosis
occurs with diarrhea; alkaline fluid is lost from the lower gastrointestinal tract