Med Surg 1 Chapter 30
A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question should the nurse ask first?
"Do you experience shortness of breath with basic activities?"
A nurse is teaching a client who has cystic fibrosis (CF). Which statement should the nurse include in this client's teaching?
"Eat a well-balanced, nutritious diet."
A nurse cares for a client with chronic obstructive pulmonary disease (COPD). The client states that he no longer enjoys going out with his friends. How should the nurse respond?
"Share any thoughts and feelings that cause you to limit social activities."
The nurse is teaching a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home. Which statement indicates the client correctly understands the teaching?
"I plan to use cotton balls to cushion the oxygen tubing on my ears."
The nurse is caring for a client who is prescribed a long-acting beta2 agonist. The client states, "The medication is too expensive to use every day. I only use my inhaler when I have an attack." How should the nurse respond?
"It is important to use this type of inhaler every day. Let's identify potential community services to help you."
A pulmonary nurse cares for clients who have chronic obstructive pulmonary disease (COPD). Which client should the nurse assess first?
A 52-year-old in a tripod position using accessory muscles to breathe
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?
Administer pain medication and encourage the client to take deep breaths
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?
Cover the insertion site with sterile gauze
A nurse cares for a client with a 40-year smoking history who is experiencing distended neck veins and dependent edema. Which physiologic process should the nurse correlate with this client's history and clinical manifestations?
Increased pulmonary pressure creating a higher workload on the right side of the heart
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.)
Keep an intravenous line dedicated strictly to the infusion Ensure that there is always a backup drug cassette available Use strict aseptic technique when using the drug delivery system
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?
Keep padded clamps at the bedside for use if the drainage system is interrupted
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?
The client places his or her hands on his or her abdomen
A nurse assesses a client who has a chest tube. For which manifestations should the nurse immediately intervene? (Select all that apply.)
Tracheal deviation Sudden onset of shortness of breath
A nurse assesses a client who has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? (Select all that apply.)
Tracheal deviation Sudden onset of shortness of breath Drainage greater than 70 mL/hr Disconnection at Y site
A nurse cares for a client who has a chest tube. When would this client be at highest risk for developing a pneumothorax?
When the tube becomes disconnected from the drainage system
