A patient with chronic bronchitis who has a new prescription for Advair Diskus (combined fluticasone and salmeterol) asks the nurse the purpose of using two drugs. The nurse explains that a. one drug decreases inflammation, and the other is a bronchodilator The nurse has completed patient
teaching about the administration of salmeterol (Serevent) using a metered-dose inhaler (MDI). Which action by the patient indicates good understanding of the teaching? a. The patient attaches a spacer before using the MDI. When preparing a patient with possible asthma for pulmonary function testing, the nurse will teach the patient to d. withhold bronchodilators for 6 to 12 hours before the examination. Which information will the nurse include when teaching the patient with asthma about the prescribed medications? d. Tremors are an expected side effect of rapidly acting bronchodilators. When the nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack, which finding is the best indicator that the therapy has been effective? b. Oxygen saturation is >90%. A patient seen in the asthma clinic has recorded daily peak flows that are 85% of the baseline. Which action will the nurse plan to take? c. Instruct the patient to continue to use current medications. Which action by a patient who has asthma indicates a good understanding of the nurse’s teaching about peak flow meter use? c. The patient uses the albuterol (Proventil) metered-dose inhaler (MDI) for peak flows in the yellow zone. A 32-year-old patient who denies any history of smoking is seen in the clinic with a new diagnosis of emphysema. The nurse will anticipate teaching the patient about a. 1-antitrypsin testing. Which information about a newly admitted patient with chronic obstructive pulmonary disease (COPD) indicates that the nurse should consult with the health care provider before administering the prescribed theophylline? d. The patient takes cimetidine (Tagamet) 150 mg daily. A patient with chronic bronchitis has a nursing
diagnosis of impaired breathing pattern related to anxiety. Which nursing action is most appropriate to include in the plan of care? d. Teach the patient how to effectively use pursed lip breathing. A patient with chronic obstructive pulmonary disease (COPD) has a nursing diagnosis of imbalanced nutrition: less than body requirements. An appropriate intervention for this problem is to d. offer high calorie snacks between meals and at bedtime. When the nurse is interviewing a patient with a new diagnosis of chronic obstructive pulmonary
disease (COPD), which information will help most in confirming a diagnosis of chronic bronchitis? d. The patient complains about a productive cough every winter for 3 months. After the nurse has finished teaching a patient about pursed lip breathing, which patient action indicates that more teaching is needed? b. The patient puffs up the cheeks while exhaling. Which finding by the nurse for a patient with a nursing diagnosis of impaired gas exchange will be most useful in evaluating the effectiveness of treatment? a. Pulse oximetry reading of 91% To evaluate the effectiveness of therapy for a patient with cor pulmonale, the nurse will monitor the patient
for c. jugular vein distention. When a hospitalized patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen, the best action by the nurse is to b. maintain the pulse oximetry level at 90% or greater. Which information will the nurse include in teaching a patient with chronic obstructive pulmonary disease (COPD) who has a new prescription for home oxygen therapy? d. Oxygen use can improve the patient’s prognosis and quality of life. A patient is receiving 35% oxygen via a Venturi mask. To ensure the correct amount of oxygen delivery, it is most important that the nurse a. keep the air entrainment ports clean and unobstructed. Postural drainage with percussion and vibration is
ordered twice daily for a patient with chronic bronchitis. The nurse will plan to a. carry out the procedure 3 hours after the patient eats. When developing a teaching plan to help increase activity tolerance at home for a 70-year-old with severe chronic obstructive pulmonary disease (COPD), the nurse should teach the patient that an appropriate exercise goal is to b. walk for a total of 20 minutes daily. A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, “I wish I were dead! I cannot do anything for myself anymore.” Based on this information, which
nursing diagnosis is most appropriate? d. Chronic low self-esteem related to increased physical dependence A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital. How can the nurse best position the patient to improve gas exchange? b. Sitting up at the bedside in a chair and leaning slightly forward Which diagnostic test will the nurse plan to discuss with a 54-year-old patient with progressively increasing dyspnea who is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease
(COPD)? b. Pulmonary function testing Which action will be included in the plan of care for a 23-year-old with cystic fibrosis (CF) who is admitted to the hospital
with increased dyspnea? d. Perform chest physiotherapy every 4 hours. A patient who is hospitalized with cystic fibrosis
(CF) coughs up large quantities of thick green mucus. The nurse will plan to teach the patient about d. aerosolized tobramycin (TOBI). A 20-year-old patient with
cystic fibrosis (CF) tells the nurse that she is considering having a child. Which initial response by the nurse is best? b. “Do you need any information to help you with the decision?” A patient with chronic obstructive pulmonary disease (COPD) has rhonchi throughout the lung fields and a chronic, nonproductive cough. Which nursing action will be most effective? c. Educate the patient to use the Flutter airway clearance device. After the nurse has completed diet teaching for a patient with chronic
obstructive pulmonary disease (COPD) who has a body mass index (BMI) of 20, which patient statement indicates that the teaching has been effective? b. “I will have ice cream as a snack every day.” When teaching the patient with chronic obstructive pulmonary disease (COPD) about exercise, which information should the nurse include? b. “Use the bronchodilator before you start to exercise.” Which information given by an asthmatic patient while the nurse is doing the admission assessment is most indicative of a need for a change in therapy? d. The patient’s only medications are albuterol (Proventil) and salmeterol When the nurse takes an admission history for a patient with possible asthma who has new-onset wheezing and shortness of breath, which information may indicate a need for a change in therapy? c. The patient takes propranolol (Inderal) for hypertension. Which topic will the nurse include in medication teaching for a patient with newly-diagnosed persistent asthma? c. Self-administration of inhaled corticosteroids A patient with cystic fibrosis (CF) has blood glucose levels that are consistently 200 to 250 mg/dL. Which nursing action will the nurse plan to implement? b. Educate the patient about administration of insulin. When caring for a
patient with a history of asthma, which assessment finding should the nurse communicate immediately to the health care provider? c. Use of accessory muscles in breathing Which action should the nurse anticipate taking first when a patient who is experiencing an asthma attack develops bradycardia and a decrease in wheezing? a. Assist with endotracheal intubation. A patient who is experiencing an acute asthma attack is admitted to the emergency department. The nurse’s first action should be to a. listen to the patient’s breath sounds. Which finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider? b. Flushing and dizziness The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. Which patient will require the most rapid action by the nurse? a. 20-year-old with ABG results: pH 7.28, PaCO2 60 mm Hg, and PaO2 58 mm Hg Which of these nursing actions included in the care plan for a patient with chronic obstructive pulmonary disease (COPD) should the nurse delegate to experienced nursing assistive personnel (NAP)? a. Obtain oxygen saturation using pulse oximetry. A patient with asthma who has a baseline peak flow reading of 600 mL calls the nurse, stating that the current peak flow is 420 mL. Which action should the nurse take first? b. Instruct the patient to use the prescribed albuterol (Proventil). The following medications are prescribed by the health care provider for a patient having an acute asthma attack. Which one will the nurse administer first? b. albuterol (Ventolin) 2.5 mg per nebulizer The nurse has received a change-of-shift report about the following patients with chronic obstructive pulmonary disease (COPD). Which patient should the nurse assess first? a. A patient with a respiratory rate of 38 What actions does the nurse include in teaching a patient to use an inhaler with a spacer select all that apply?Breathe in Slowly. Put the spacer between your teeth and close your lips tightly around it.. Keep your chin up.. Start breathing in slowly through your mouth.. Spray one puff into the spacer by pressing down on the inhaler.. Keep breathing in slowly. Breathe as deeply as you can.. In which order should the nurse instruct the client to use an inhaler?Put the inhaler in your mouth. Press down on the inhaler quickly to release the medicine as you start to breathe in slowly. Breathe in slowly for 3 to 5 seconds. Hold your breath for 10 seconds to allow medicine to go deeply into your lungs.
Which instruction will the nurse include when teaching a patient how do you do huff coughing?The Huff Coughing Technique:. Sit up straight with chin tilted slightly up and mouth open.. Take a slow deep breath to fill lungs about three quarters full.. Hold breath for two or three seconds.. Exhale forcefully, but slowly, in a continuous exhalation to move mucus from the smaller to the larger airways.. Which position will the nurse use when caring for a patient who is experiencing an asthma?During an asthma attack, the patient should sit down, preferably in a semi-fowler position to help with breathing (Wilson, 2015). The patient should try to relax as much as possible and breathe from their diaphragm.
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