NUR336 Evolve: Asthma and COPD - TTC

Which statement by a patient with chronic obstructive pulmonary disease (COPD) indicates the need for additional follow-up instruction?

"I don't need to get a flu shot."

The nurse assesses a patient who has chronic obstructive pulmonary disease (COPD) 15 minutes after an aerosolized bronchodilator has been administered. Which finding prompts the nurse to notify the provider?

Oxygen saturation of 87%.

In teaching a patient about asthma medication management, the nurse reinforces the need to use a long-acting beta agonist (LABA) as directed. Which statement by the patient indicates a need for further teaching?

"I may use the LABA as needed for wheezing and coughing."

After receiving education on the correct use of emergency drug therapy for asthma, which statement by the patient indicates a correct understanding of the nurse's instructions?

"I must have my emergency inhaler with me at all times."

The nurse is teaching a patient with asthma about using a controller medication. Which statement by the patient indicates a need for further teaching?

"I should take this medication as needed when my symptoms become more severe."

A patient who has a risk of a faulty pair of alleles for the alpha 1-antitrypsin (AAT) protein gene and who has a history of cigarette smoking is concerned about the risk of chronic obstructive pulmonary disease (COPD). Which statement by the nurse accurately answers the patient's concerns?

"If both pairs of AAT genes are faulty, you are likely to develop COPD, even if you don't smoke."

A patient has been diagnosed with asthma. Which statement below indicates that the patient correctly understands how to use an inhaler with a spacer correctly?

"If the spacer makes a whistling sound, I am breathing in too rapidly."

A patient asks the nurse how montelukast helps asthma. What is the best response by the nurse?

"It prevents the synthesis of leukotrienes that can cause bronchoconstriction and inflammation."

The nurse is teaching a patient about self-management of asthma. Which statement by the patient indicates a need for further teaching?

"The fluticasone inhaler is used as a rescue medication."

The nurse is providing teaching about home management of chronic obstructive pulmonary disease (COPD). The patient says, "What difference does it make? This isn't going to get any better anyway." What is the nurse's best response?

"This is a chronic condition with exacerbations and remissions, and with proper care, you can slow the progression of COPD."

An asthmatic patient who is allergic to pollen is prescribed cromolyn sodium; however, the patient reports that it does not help relieve symptoms during an asthma attack. Which instruction would be beneficial to the patient?

"Use cromolyn sodium on a routine basis to prevent an asthma attack, not as a rescue inhaler."

To some degree, most patients with chronic obstructive pulmonary disease (COPD) have which pathologic processes present?

-Bronchitis. -Emphysema.

A patient with asthma reports having chronic pain. The nurse anticipates the provider will recommend which pain medication for this patient?

Acetaminophen (TYLENOL).

A patient with asthma performs a peak flow assessment, which is 60% of normal and in the yellow range, and has an oxygen saturation of 94% on room air. Which initial action does the nurse take?

Administer the ordered PRN short-acting beta2 agonist.

Inhaled corticosteroids are typically used to treat which symptom of asthma?

Airway inflammation.

What best describes the pathophysiology involved in a patient who has asthma as a lower respiratory disease?

Airway obstruction secondary to inflammation and/or bronchoconstriction secondary to airway hyperresponsiveness

A patient with asthma has pneumonia, is reporting increased shortness of breath, and has inspiratory and expiratory wheezes. All of these medications are prescribed. Which medication should the nurse administer first?

Albuterol 2 inhalations.

The nurse is teaching a patient with asthma about using the following medications. Which medication does the nurse teach the patient to use first?

Albuterol 2 puffs.

A patient who has emphysema tells the nurse that the prescribed inhaled corticosteroid medication does not help at all. Which action by the nurse is correct?

Ask the patient to describe how frequently the medication is used.

The nurse is performing an admission history on a patient with COPD. The patient reports increased difficulty sleeping, eating, and dressing and has trouble walking even short distances. To facilitate completion of the assessment, what does the nurse do next ?

Asks the patient to sit on the edge of the bed and lean forward over the bedside table.

What two assessment findings are changes secondary to chronic obstructive pulmonary disease (COPD)?

Barrel chest and finger clubbing.

The nurse is caring for a patient with COPD who reports increased fatigue and nausea. The nurse notes distended neck veins, bounding peripheral pulses, dependent edema, and cyanosis of the lips and hands. The nurse notifies the health care provider of which condition?

Cor pulmonale.

When reviewing asthma management with a 65-year-old patient, what topic is most important for the nurse to include?

Correct use of controller medications.

The family of a patient having an asthma attack has called in seeking guidance for treatment recommendations on the STEP protocol. Which reported factor indicates the patient should go to the emergency department immediately ?

Decreasing peak expiratory flow (PEF) despite the use of reliever drugs.

What does the nurse do first when setting up a safe environment for the new patient on oxygen?

Ensures that no combustion hazards are present in the room.

The nurse is teaching a patient who has chronic obstructive pulmonary disease (COPD) about the need to prevent respiratory infections. Which topic does the nurse include in the patient's teaching?

Getting an annual influenza vaccine.

A patient who is admitted for treatment of an acute asthma exacerbation has a low Pao 2 and an elevated Paco 2. These lab values indicate which phase or type of asthma attack?

Late phase.

Which chemical is responsible for a prolonged inflammatory response, leading to airway obstruction?

Leukotriene.

A patient's family is expressing concern about the new diagnosis of chronic obstructive pulmonary disease (COPD) in their loved one. What does the nurse do next ?

Listen to the basis of the family's concerns and then develop a focused teaching plan.

What is the nurse's priority for care in the postoperative period for a patient with severe chronic obstructive pulmonary disease (COPD) who has undergone lung reduction surgery?

Monitor the patient's oxygen saturation levels continuously and use the incentive spirometer.

All of these patients are being cared for on the intensive care step-down unit. Which patient should the charge nurse assign to an RN who has floated from the pediatric unit?

Patient with acute asthma episode who is receiving oxygen at FiO2 of 60% by nonrebreather mask.

Which medication is an example of a long-acting beta 2agonist (LABA) used in asthma management?

Salmeterol.

A patient with severe chronic obstructive pulmonary disease (COPD) is using home oxygen at a flow rate of 4 L/min via nasal cannula. He calls the clinic to report only moderate improvement in shortness of breath. What does the nurse advise this patient?

Shortness of breath may continue even with oxygen therapy.

The nurse has been teaching improved airflow techniques to the patient, who has continued to have restrictive breathing problems. Which is the best indicator of success?

SpO2 level of 92% after ambulating 50 feet.

A patient is admitted with asthma. How is this disease differentiated from other chronic lung disorders?

The patient is symptom-free between exacerbations.