COPD practice Flashcards
Which patient has early clinical manifestations of hypoxemia?
a) A 48-yr-old patient who is intoxicated and acutely disoriented to time and place.
b) A 67-yr-old patient who has dyspnea while resting in the bed or in a reclining chair.
c) A 72-yr-old patient who has four new premature ventricular contractions per minute.
d) A 94-yr-old patient who has renal insufficiency, anemia, and decreased urine output.
c
Early clinical manifestations of hypoxemia include dysrhythmias (e.g., premature ventricular contractions), unexplained decreased level of consciousness (e.g., disorientation), dyspnea on exertion, and unexplained decreased urine output.
The nurse is performing a respiratory assessment. Which finding best supports the presence of impaired airway clearance?
a) Basilar crackles
b) Oxygen saturation of 85%
c) Presence of greenish sputum
d) Respiratory rate of 28 breaths/min
a
The presence of adventitious breath sounds indicates that there is accumulation of secretions in the lower airways. This would be consistent with impaired airway clearance because the patient is retaining secretions. The rapid respiratory rate, low oxygen saturation, and presence of greenish sputum may occur with other lower respiratory problems.
During discharge teaching for an older adult patient with chronic obstructive pulmonary disease (COPD) and pneumonia, which vaccine should the nurse recommend that this patient receive?
a) Pneumococcal
b) Staphylococcus aureus
c) Haemophilus influenzae
d) Bacille-Calmette-Guérin (BCG)
a
The pneumococcal vaccine is important for patients with a history of heart or lung disease, recovering from a severe illness, age 65 years or older, or living in a long-term care facility. A S. aureus vaccine has been researched but not yet been effective. The H. influenzae vaccine would not be recommended as adults do not need it unless they are immunocompromised. The BCG vaccine is for infants in parts of the world where tuberculosis is prevalent.
The nurse is caring for a patient with impaired airway clearance. What is the priority nursing action to assist this patient to expectorate thick lung secretions?
a) Humidify the oxygen as able.
b) Administer a cough suppressant q4hr.
c) Teach patient to splint the affected area.
d) Increase fluid intake to 3 L/day if tolerated.
d
Although several interventions may help the patient expectorate mucus, the highest priority should be on increasing fluid intake, which will liquefy the secretions so that the patient can expectorate them more easily. Humidifying the oxygen is also helpful but is not the primary intervention. Teaching the patient to splint the affected area may also be helpful in decreasing discomfort but does not assist in expectoration of thick secretions.
Pt is concerned that he may have asthma. Of the symptoms that he describes to the nurse, which ones suggest asthma or risk factor for athma?SATA
a) Allergic rhinitis
b) Prolonged inhalation
c) Cough, especially at night
d) Gastric reflect or hearburn
e) History of chronic sinusitis
a,c,d,e
Which findings indicate that a pt is developing status asthmaticus? SATA
a) PERF<300L/min
b) Positive sputum culture
c) Unable to speak in complete sentences
d) Lack of response to conventional tratment
e) Chest x-ray shows hyperinflated lungs and a flattened diahragm
a,c
Which statement indicates the pt with asthma requires further teaching about seld-acre?
a) I use my corticosteroid inhaler when I feel short of breath
b) I get a flu shot every year and see my HCP if I have an upper respiratory tract infection
c) I use my inhaler before I visit my aunt who has a cat, but I only visit for a few minutes because of my allergies
d) I walk 30 mn every day but sometimes I have to use my bronchodilator inhaler before walking to prevent me from getting short of breath
a
The plan of care for pt with COPD should include? SATA
a) exercise such as walking
b) high flow rate O2 administration
c) low-dose chronic oral corticosteroid therapy
d) use of pea flow meter to monitor the progression of COPD
e) breathing exercise such as pursed-lip breathing that focus on exhalation
a,e
The major advantage of a Venturi mask is that tit can
a) deliver up to 80 %O2
b) provide continuous 100% humidity
c) deliver a precise concentration O2
d) be used while a pt eats and sleeps
c
precise=正確な
Which guideline should the nurse include when teaching a pt how to use a metered-dose-inhaler(ADI)
a) after activating the MDI, breathe in as quickly as you can
b) estimate the amount of remaining medicine in the MDIby floating the canister in water
c) Dissemble the plastic canister from the inhaler and rinse both piecess under running water every week
d) To determine how long canister will last,divide the total number of puffs i the canister by the puffs needed per day
d
**
A pt who has bronchiectasis ask the nurse, “ What condition would warrant a call to the clinic?”
a) blood clots in the sputum
b) sticky sputum o a hot day
c) inc shortness of breath after eating a large meal
d) preduction of large amounts of suputum ona daily basis
a
A nurse in the ED is caring is caring for a pt who is experiencing an acute asthma attack. Which of the following assesment indicates that the respiratory status in declining? SATA
a) SaO2 95%
b) Wheezing
c) Retraction of sternal muscles
d) Pink mucous membranes
e) Tachycardia
b,c,e
b-indicate airway narrowing
c-associated with inc work of brathing
A nurse is caring for a pt 2 hours after admission. The pt has a SaO2 of 91%, exhibits audible wheezing, and is using accessory muscles when breathing, WHich of the following classes of meds should the nurse expect to administer?
a) antibiotic
b) b-blocker
c) antiviral
d) b-agonist
d
dilation of the bronchioles to relive whezzing and open airway
bronchodilator=prevent asthma attack, not need to take with food
A nurse is providing discharge teaching to a pt who has COPD and a new prescription for albuterol. WHich of the following statements by the pt indicated an understanding of the teaching?
a) Thi smed can increase my blood sugar levels
b) This med can decrease my immune response
c) I can have an inc in my HR while taking this med
d) I can have mouth sores while taking this med
c
bronchodilator=tachycardia
a-corticosteroid cause inc sugar
b-corticosteroid can decrease immune
c-corticosteroid can cause
A nurse is preparing to administer an initial dose of prednisone to a pt who has COPD. The nurse should monitor for which of the following adverse effects of this med? SATA
a) Hypokalemia
b) Tachycardia
c) Fluid retention
d) Nausea
e) Black, tarry stools
prednisone=steroid
a,c,e
b,d=bronchodilator
