PrepU- Respiratory

A client is being treated in the ED for respiratory distress coupled with bacterial pneumonia. The client has no medical history. However, the client works in a coal mine and smokes 10 cigarettes a day. The nurse anticipates which order based on the client's immediate needs?

Administration of antibiotics

The nurse is performing a routine assessment of a client whose medical record indicates a history of asthma. What assessment findings would the nurse expect? Select all that apply.

Airway inflammation Damaged airway mucosa

A client with chronic obstructive pulmonary disease (COPD) reports increased shortness of breath and fatigue for 1 hour after awakening in the morning. Which of the following statements by the nurse would best help with the client's shortness of breath and fatigue?

"Delay self-care activities for 1 hour."

The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?

"I can't use a spacer or holding chamber with the MDI."

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary?

"I do not need to rinse my mouth with this type of inhaler."

Which statement is true about both lung transplant and bullectomy?

Both procedures improve the overall quality of life of a client with COPD.

The pediatric unit has multiple clients experiencing upper respiratory system complications. Which pediatric client is at the highest risk for respiratory distress?

2-year-old child with epiglottitis

Which statement describes emphysema?

A disease of the airways characterized by destruction of the walls of overdistended alveoli

A client with a history of respiratory problems tells the nurse that he would like to explore strategies to reduce his risks. He also mentions being currently unemployed and not wanting to pursue costly strategies. What would the nurse emphasize as the single most cost-effective intervention to reduce the risk of developing COPD or slow its progression?

Cessation of smoking

Which of the following statements best captures the etiology of the acute response phase of extrinsic (atopic) asthma?

Chemical mediators are released from pre-sensitized mast cells.

A client has undergone pulmonary diagnostic studies where the results show a mismatching of ventilation and perfusion. Which diagnosis is most likely associated with this finding?

Chronic obstructive pulmonary disease

A client is at risk for emphysema. When reviewing information about the condition with the client, which would the nurse emphasize as the most important risk factor for emphysema?

Cigarette smoking

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.

60 mm Hg; 90%

A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?

A 65-year-old male with asthma

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

Albuterol causes relaxation of the bronchial smooth muscles.

A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?

An inhaled beta2-adrenergic agonist

A client is diagnosed with a chronic respiratory disorder. After assessing the client's knowledge of the disorder, the nurse prepares a teaching plan. This teaching plan is most likely to include which nursing diagnosis?

Anxiety

You are caring for a client with obstructive pulmonary disease. Your nursing care includes diagnoses, outcomes, and interventions for what?

Atelectasis

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?

Coffee

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

Cromolyn

The diagnosis of pulmonary hypertension associated with chronic obstructive pulmonary disease (COPD) is suspected when which of the following is noted? Select all that apply.

Dyspnea and fatigue disproportionate to pulmonary function abnormalities Right ventricular enlargement Elevated plasma brain natriuretic peptide (BNP) Enlargement of central pulmonary arteries

Which exposure acts as a risk factor for and accounts for the majority of cases of chronic obstructive pulmonary disease (COPD)?

Exposure to tobacco smoke

A nurse evaluates the results of a spirometry test to help confirm a diagnosis of obstructive lung disease. Which one of the following results indicates an initial early stage of COPD? (FEV1 refers to forced expired volume in 1 second.)

FEV1 > 80%

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?

Mast cells

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?

Providing sufficient oxygen to improve oxygenation

A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?

Relaxation of smooth muscle

A child is brought to the emergency department with an asthma attack. Assessment revealed the use of accessory muscles, a weak cough, audible wheezing sound, moist skin, and tachycardia. Which drug will the nurse anticipate administering first?

Short-acting beta 2-adrenergic agonists such as albuterol (SABA)

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

Sputum and a productive cough

Which is a criterion for diagnosing moderately persistent asthma?

Symptoms occur daily.

Which of the following are risk factors for the development of chronic obstructive pulmonary disease (COPD)? Select all that apply.

Tobacco smoke Occupational dust Air pollution Infection Second-hand smoke

Which of the following is not a primary symptom of COPD?

Weight gain

A client is admitted for a relapse for sarcoidosis. Knowing this is usually caused by an inflammatory process, the nurse can anticipate administering:

a corticosteroid.

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for:

atelectasis.

A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?

chocolate

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient

has a high coffee intake.

A client with asthma comes to the emergency department very anxious due to increasing shortness of breath. Physical assessment reveals tachypnea, and an arterial blood gas shows decreased carbon dioxide levels and hypoxemia. What is the most likely cause of the decreased carbon dioxide levels?

hyperventilation

The classification of grade I COPD is defined as

mild COPD.

The classification of Stage III of COPD is defined as

severe COPD.

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma?

"I'm going to have this hospital worker take a picture of your lungs."

The clinic nurse is caring for a client who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The client asks the nurse what COPD means. What would be the nurse's best response?

"It means that the lungs have been damaged in such a way that there is limited airflow in and out of the lungs."

A client with chronic obstructive pulmonary disease (COPD) and cor pulmonale is being prepared for discharge. The nurse should provide which instruction?

"Weigh yourself daily and report a gain of 2 lb in 1 day."

A client's spouse states that she is worried about her husband because he appears to be breathing "really hard." The nurse performs a respiratory assessment. What findings would indicate a need for further interventions?

BP 122/80, HR 116, R 24, pale and clammy skin, temp 101.3 °F (38.5 °C)

A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one type of disorder within its classification. Which of the following is part of that disorder?

Emphysema

A client has chronic obstructive pulmonary disease (COPD) and is exhibiting shallow respirations of 32 breaths per minute and a pulse oximetry of 93% despite receiving nasal oxygen at 2 L/minute. What action should the nurse take?

Encourage the client to exhale slowly against pursed lips.

In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match? Select all that apply.

Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

Asthma

The nurse is teaching the parents about medications for their 9-year-old boy who has a respiratory disorder. The nurse would be alert for an increased need for medications if the child was exposed to second-hand smoke and has which condition?

Asthma

What is the most common first-line therapy for relief of an acute asthma attack?

Beta2-adrenergic agonist

In which grade of COPD is the forced expiratory volume (FEV) less than 30%?

IV

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?

Oxygen through nasal cannula at 2 L/minute

The nurse is assigned the care of a 30-year-old client diagnosed with cystic fibrosis (CF). Which nursing intervention will be included in the client's care plan?

Performing chest physiotherapy as ordered

Which client is exhibiting signs of advanced chronic obstructive pulmonary disease (COPD)?

client sitting in bed resting elbows on the overbed table, expiratory wheezes noted

A child is experiencing an acute exacerbation of asthma. Which quick-acting treatment is most appropriate for this client?

beta-adrenergic agonists

The mother of a child with asthma tells the nurse that she occasionally gives her child the steroid medicine she takes for her rheumatoid arthritis when the child has a "flare-up" of asthma. "It's easier than going to the hospital or doctor every time a flare-up happens," the mother says. What is the best response by the nurse?

"I'm sure it must be difficult to cope with the flare-ups, but there are many side effects from steroid use and the physician needs to monitor your child's asthma symptoms."

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?

"When I am short of breath, I will increase the use of my fluticasone."

A client with end-stage COPD and heart failure asks the nurse about lung reduction surgery. What is the best response by the nurse?

"You and your physician should discuss the options that are available for treatment."

A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply.

Inflamed airways that obstruct airflow Mucus secretions that block airways Overinflated alveoli that impair gas exchange

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?

Lung sounds

An asthma educator is teaching a new patient with asthma and his family about the use of a peak flow meter. What does a peak flow meter measure?

Highest airflow during a forced expiration

Which factors increase the risk that a client will develop chronic obstructive pulmonary disease (COPD)? Select all that apply.

History of tobacco use History of asthma

Which factor is most likely to precipitate an asthmatic attack in a child with a diagnosis of extrinsic, or atopic, asthma?

Pet dander

In COPD, the body attempts to improve oxygen-carrying capacity by increasing the amount of red blood cells. Which term refers to this process?

Polycythemia

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis

A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?

Salmeterol is contraindicated based on his wife's condition.

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:

diminished or absent breath sounds on the affected side.

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breathe. The signs the nurse noted indicate the child likely has:

epiglottitis.

The term chronic obstructive pulmonary disease (COPD) can be a combination of two types of obstructive airway diseases. Which disease processes have been identified as being part of COPD?

chronic bronchitis and emphysema