Med surg 1 Respiratory scenario's

While teaching a class of new parents, which child does the nurse correctly identify as having an increased risk of SIDS?

premature infants and low birth weight

A client requires a chest tube to be inserted in the right upper chest. Which action is part of the nurse's role?

preparing the chest tube drainage system

A nurse is caring for a client who underwent a total hip replacement. Which intervention should the nurse implement in the clients care to prevent dislocation of the new prosthesis?

Avoid moving the extremity into positions that cause internal rotation

The nurse is caring for a group of clients. Which client should be most closely monitored for the development of respiratory failure?

A client with Guillain-Barre' syndrome

During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. Which physiological response should the nurse monitor this client for?

A drop in the clients heart rate

The client who was diagnosed with pneumonia 2 days prior comes to the emergency department with a sudden onset of severe shortness of breath. The chest x-ray shoes fluid in the alveolar spaces. Which disease should the nurse suspect this client to have?

Acute respiratory distress syndrome (ARDS)

An older adult client has just been admitted with pneumonia. The client tells the nurse that they had never had pneumonia before, and nobody in the family has ever suffered from pneumonia and don't understand how I contracted this disease. which statement by the nurse would be more appropriate?

Advanced age is a risk factor for developing pneumonia

A child is diagnosed with Tuberculosis (TB). When reinforcing education for the parents about care of the child, which statement made by the parent would indicate a need for further instruction?

As long as I keep a surgical mask on I will not get TB

The parent of a 2 yr old child with epiglottitis states they have to leave to pick up another child from school. The 2 yr old child begins to cry and sounds more stridors. Which intervention by the nurse is best?

Ask the parents if someone else can pick up the other child.

The client underwent an open cholecystectomy for which complications should the nurse monitor this client for the next 24 hours?

Atelectasis

A client has symptoms of acute asthma every time the family eats at a Chinese restraint. Which instruction should the nurse reinforce for this client to avoid complications?

Avoid Chinese food because its a trigger for you

The nurse cares for a client who has experienced a stroke. During morning round, the nurse observes that the client has deeper breaths followed by shallower breaths with apneic periods. Which breathing patterns should the nurse document?

Cheyne-Stokes

A client is placed on oxygen therapy via nasal cannula. Which should be the first action by the nurse?

Confirm the health care provider's order for oxygen

A child admitted with pneumonia has a history of cystic fibrosis (CF). Which statement made by the parents best demonstrates an understanding of cystic fibrosis?

Cystic Fibrosis (CF) is an inherited disease characterized by an abnormality in the body's salt, water and mucus making cells.

The nurse is caring for a child with a respiratory infection. Which precaution should the nurse take to adhere to infection control measures?

Enforce hand washing

A clients with chronic obstructive lung disease tells the nurse that he feels SOB. The clients respiratory rate is 36 and nurse auscultates diffuse wheezes. His arterial oxygen saturation is 84%. The nurse calls the assigned RT to administer a prescribed nebulizer treatment. The therapist says " I have several more percussions to do on the unit where I am now. As soon as I'm done, ill come assess the client." the nurse's most appropriate action is to?

Give the nebulizer treatment herself

The nurse is caring for a child with a diagnosis of croup. What advise should the nurse give to the parent when concern is expressed about the child waking up at night due to the cough?

Hold child in the bathroom with a hot shower running allowing the steam to fill the room

A nurse reinforce teaches a group of police officers about the spread of TB. Which statement by an officer indicates that teaching has been effective?

I could get TB if I inhale infected droplets when an infected individual coughs.

A client is being screened in the clinic for tuberculosis. The nurse performs a PPD test on the right forearm. Which statement made by client indicates a need for further teaching?

I should return in 24 hours for the results

The nurse is caring for a child with increased laryngotracheal edema and early signs of impending airways obstruction. The nurse should observe for which warning sign?

Increased heart and respiratory rates, retractions and restlessness

A 48 yr old client is admitted for suspected pulmonary emboli. Upon arrival in the intensive care unit, the client is alert and oriented. He insists on anxiously walking around the room. Which nursing actions takes priority for this client?

Initiate bed rest with the head of the bed elevated at least 45 degrees, administer supplement O2, and monitor the clients respiratory status.

A client with lung cancer has developed an intractable, nonproductive cough that is unrelieved by nonopioid antitussive agents. the physician prescribes codeine 10mg PO Q4 hrs. When discussing this medication with a nursing colleague, which statement that accurately describes codeine will the nurse include?

It is a centrally acting antitussive and can cause dependence

A client is hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. While monitoring the clients , which clinical findings that commonly accompany respriatory alkalosis would the nurse expect to assess

Light-headedness or paresthesia

A client who has just delivered a full term baby tells the nurse that sudden infant death syndrome (SIDS) is a big fear. When reinforcing education the mother about SIDS, which factor is identified as being associated with SIDS?

Low birth weight

A client is receiving supplemental 02. When determining the effectiveness of 02 therapy, which arterial blood gas value is most important?

Partial pressure of arterial (Pa02)

A 69 year old client comes to the emergency department with a history of productive cough, night sweats, and a 30lb weight loss over the past 8mnths. A diagnosis of tuberculosis is suspected. which intervention is necessary for this client?

Place the client in a private room with negative pressure and implement airborne precautions.

When caring for an infant with bronchopulmonary dysplasia, which is the best intervention to avoid fatigue and to decrease respiratory effort?

Place the infant on a set schedule

Which factor does the nurse inform the parents will place a child at increased risk for an asthma related death?

Prior admission to an intensive care unit for asthma

The nurse is administrating theophylline to a client. What is the drug's therapeutic action when used to treat asthma?

Relaxes bronchial smooth muscle

An older adult client who has chronic respiratory disease comes to the clinic for a 6-mnth check up. The nurse informs the client its time for the pneumococcal and flu vaccine. What would be the nurse's best explanation to the client for these injections?

Respiratory infections can cause severe hypoxia and possibly death in clients with chronic respiratory diseases.

A client arrives in the local clinic and reports a chronic cough and fatigue. The client admits to smoking 2 packs of cigs daily for 10 years and also informs the nurse a 9kg weight loss over the past 2 months. Which test required for a definitive diagnosis of cancer does the nurse prepare the client for?

Surgical biopsy

For a client with chronic obstructive pulmonary disease, which nursing intervention would help maintain a patent airway?

Teaching the client how to perform controlled coughing.

A client with chronic obstructive pulmonary disease, who has been receiving mechanical ventilation for the past 5 years, expresses to a nurse the desire to have treatment withdrawn. The nurse recognizes which statement about the clients legal rights is true in this situation?

The client has the right to refuse treatment at any time

When reading the h&p of a client diagnosed with emphysema, the nurse notes that the client has decreased breath sounds in the base bilaterally. The nurse determines that this is most likely due to which finding?

over-inflation of the lungs

A young adult was told that he had a significant reaction to the Mantoux test. The client asks the nurse what is the meaning of this significant reaction. How does the nurse appropriately respond?

You have been exposed to tuberculosis

After a tonsillectomy, a client is being prepared for discharged. The nurse should instruct the client to report which sign or symptom?

bleeding

A 3- yr old is receiving ampicillin for acute epiglottitis. Which sign would lead the nurse to suspect that the child is experiencing a common adverse effect of this drug?

generalized rash

The nurse is caring for a client who recently underwent a tracheostomy. The first priority when caring for a client with a tracheostomy is?

keeping the airway patent

a client is admitted to the hospital with a diagnosis of respiratory failure. The client is intubated, and placed on 100% FiO2, and is coughing up copious secretions. Which intervention has priority?

suctioning the client