Chapter 24: Management of Patients w/Chronic Pulmonary Disease

A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?

Administer an inhaled beta-adrenergic agonist

A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give?

To gain prompt control of inadequately controlled, persistent asthma

The nurse is assessing a patient whose respiratory disease in characterized by chronic hyperinflation of the lungs. What would the nurse most likely assess in this patient?

A barrel chest

A nurse is assessing a patient who is suspected of having bronchiectasis. The nurse should consider which of the following potential causes? Select all that apply.

Airway obstruction Pulmonary infections Genetic disorders

A nurse is caring for a patient who has been hospitalized with an acute asthma exacerbation. What drugs should the nurse expect to be ordered for this patient to gain underlying control of persistent asthma?

Anti-inflammatory drugs

An interdisciplinary team is planning the care of a patient with bronchiectasis. What aspects of care should the nurse anticipate? Select all that apply.

Antimicrobial therapy Chest physiotherapy Smoking cessation

A nurse is preparing to perform an admission assessment on a patient with COPD. It is most important for the nurse to review which of the following?

Available diagnostic tests

A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?

Bilateral wheezes

A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF?

Bronchial mucus plugging, inflammation, and eventual bronchiectasis

A nurse is working with a child who is undergoing a diagnostic workup for suspected asthma. What are the signs and symptoms that are consistent with a diagnosis of asthma? Select all that apply.

Chest tightness Wheezing Cough

A nurse is developing the teaching portion of a care plan for a patient with COPD. What would be the most important component for the nurse to emphasize?

Chronic inhalation of indoor toxins can cause lung damage.

A nurse is documenting the results of assessment of a patient with bronchiectasis. What would the nurse most likely include in documentation?

Clubbing of the fingers

A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations?

Copious sputum production

A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching?

Cough and oral thrush

A student nurse is preparing to care for a patient with bronchiectasis. The student nurse should recognize that this patient is likely to experience respiratory difficulties related to what pathophysiologic process?

Dilation of bronchi and bronchioles

An admitting nurse is assessing a patient with COPD. The nurse auscultates diminished breath sounds, which signify changes in the airway. These changes indicate to the nurse to monitor the patient for what?

Dyspnea and hypoxemia

An asthma nurse educator is working with a group of adolescent asthma patients. What intervention is most likely to prevent asthma exacerbations among these patients?

Educating patients about recognizing and avoiding asthma triggers

A nurse is evaluating the diagnostic study data of a patient with suspected cystic fibrosis (CF). Which of the following test results is associated with a diagnosis of cystic fibrosis?

Elevated sweat chloride concentration

An asthma educator is teaching a patient newly diagnosed with asthma and her family about the use of a peak flow meter. The educator should teach the patient that a peak flow meter measures what value?

Highest airflow during a forced expiration

A patients severe asthma has necessitated the use of a long-acting beta2-agonist (LABA). Which of the patients statements suggests a need for further education?

Ill make sure to use this each time I feel an asthma attack coming on.

A nurse is caring for a patient with COPD. The patients medication regimen has been recently changed and the nurse is assessing for therapeutic effect of a new bronchodilator. What assessment parameters suggest a consequent improvement in respiratory status? Select all that apply.

Increased expiratory flow rate Relief of dyspnea

A nurse has been asked to give a workshop on COPD for a local community group. The nurse emphasizes the importance of smoking cessation because smoking has what pathophysiologic effect?

Increases the amount of mucus production

The case manager for a group of patients with COPD is providing health education. What is most important for the nurse to assess when providing instructions on self-management to these patients?

Knowledge about self-care and their therapeutic regimen

A nurse is caring for a young adult patient whose medical history includes an alpha1-antitrypsin deficiency. This deficiency predisposes the patient to what health problem?

Lobular emphysema

A patient is having pulmonary-function studies performed. The patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding?

Obstructive lung disease

A nurse is caring for a 6-year-old patient with cystic fibrosis. In order to enhance the childs nutritional

Pancreatic enzyme supplementation with meals

A pediatric nurse practitioner is caring for a child who has just been diagnosed with asthma. The nurse has provided the parents with information that includes potential causative agents for an asthmatic reaction. What potential causative agent should the nurse describe?

Pets

A patient arrives in the emergency department with an attack of acute bronchiectasis. Chest auscultation reveals the presence of copious secretions. What intervention should the nurse prioritize in this patients care?

Postural chest drainage

A nurse is creating a health promotion intervention focused on chronic obstructive pulmonary disease (COPD). What should the nurse identify as a complication of COPD?

Respiratory failure

A nurse is developing a teaching plan for a patient with COPD. What should the nurse include as the most important area of teaching?

Setting and accepting realistic short- and long-range goals

A nursing is planning the care of a patient with emphysema who will soon be discharged. What teaching should the nurse prioritize in the plan of care?

Setting realistic short-term and long-range goals

A patient with emphysema is experiencing shortness of breath. To relieve this patients symptoms, the nurse should assist her into what position?

Sitting upright, leaning forward slightly

A student nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan of care that the student is developing?

Take prescribed medications as scheduled.

A nurse is admitting a new patient who has been admitted with a diagnosis of COPD exacerbation. How can the nurse best help the patient achieve the goal of maintaining effective oxygenation?

Teach the patient strategies for promoting diaphragmatic breathing.

A nurse is providing health education to the family of a patient with bronchiectasis. What should the nurse teach the patients family members?

The correct technique for providing postural drainage

A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurses best answer?

The most important risk factor for COPD is cigarette smoking.

An older adult patient has been diagnosed with COPD. What characteristic of the patients current health status would preclude the safe and effective use of a metered-dose inhaler (MDI)?

The patient has severe arthritis in her hands.

A nurse is planning the care of a client with bronchiectasis. What goal of care should the nurse prioritize?

The patient will successfully mobilize pulmonary secretions.

A nurse is providing discharge teaching for a client with COPD. When teaching the client about breathing exercises, what should the nurse include in the teaching?

Use diaphragmatic breathing

A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?

Wheezes or diminished breath sounds on auscultation