Physical Assessment
A nurse is assessing a client who has chronic respiratory insufficiency. Which of the following findings should the nurse expect as result of the long-term inadequate oxygenation?
A. Restlessness
B. Retractions
C. Clubbing of the fingers
D. Central cyanosis
C. Clubbing of the fingers
What should the nurse include in teaching about pursed-lip breathing?
Form the mouth as if preparing to whistle.
Take a breath in through the nose and out through the lips/mouth.
Not puff the cheeks.
Take breaths deep and slow.
What is the difference between Albuterol and Salmeterol?
Both are beta 2 agonists.
Inhaled albuterol (SABA) is short acting to provide rapid relief of acute manifestations or prevent exercise-induced asthma.
Salmeterol is long-acting (LABAs), such as salmeterol, primarily are used for prevention of asthma symptoms
pH 7.30
CO2 70
HCO3 26
Respiratory Acidosis
Name some low-flow oxygen devices.
Nasal canula, Simple Face mask, Partial Rebreather, Non-rebreather
A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?
A. Lethargy
B. Low CO2 levels
C. High pH level
D. Nausea and abdominal pain
A. Lethargy
What should the nurse include when teaching about use of Incentive Spirometry?
Exhale first. Then, place mouthpiece in the mouth and keep a tight mouth seal around the mouthpiece and inhale and hold breath for 3 to 5 seconds. During inhalation, the needle of the spirometry machine will rise. This promotes lung expansion and helps to prevent pneumonia and atelectasis.
Which of the following statements is true about Guaifenesin. Select all that apply.
A. This should be taken with a full glass or water
B. You may not take this with a cough suppressant
C. This medication is an expectorant
D. This is administered via MDI
A. This should be taken with a full glass or water
C. This medication is an expectorant
pH 7.35
CO2 45
HCO3 24
Normal
What is the best way to prevent chronic bronchitis?
A. Get the flu shot annually
B. Maintain a healthy weight
C. Smoking cessation
D. Eat a diet high in iron
C. Smoking cessation
Describe the difference between Kussaul respiratory pattern and Cheyne-Stokes respiratory pattern.
Cheyne-Stokes respirations gradually increase in depth, then become more shallow, followed by apnea.
Kussmaul respirations are consistently deep and fast.
A patient with suspected COPD will have a pulmonary function test tomorrow. What should the nurse include in the teaching?
PFT measure forced vital capacity (FVC), forced expiratory volume (FEV), and peek expiratory flow.
Do not smoke 6-8 hours prior to the test.
This is non-invasive, it's okay to eat.
Name some therapeutic uses for Antihistamines.
Allergic reactions (mild and severe)
Allergic rhinitis, urticaria, mild transfusion reaction or Anaphylaxis
Motion sickness
Insomnia
pH 7.48
CO2 36
HCO3 34
Metabolic Alkalosis
A nurse is assessing a client with post-op atelectasis. What sounds would the nurse expect to hear on auscultation?
Diminished or fine crackles.
Name some early signs of hypoxemia.
Tachypnea
Tachycardia
Restlessness, anxiety, confusion
Pale skin, mucous membranes
Elevated BP
Use of accessory muscles and nasal flaring
A nurse is teaching a patient with COPD about nutrition. What should the nurse include in the teaching?
Bronchodilators before meals can reduce SOB.
Eat 5-6 small meals per day.
Resting 30 min prior to meals is helpful.
Drink plenty of fluids to thin secretions and mucus
Avoid gas-forming foods.
Eat foods high in protein and calories.
What are some true statements about Acetylcysteine.
-Smells like rotten eggs
-Used to treat chronic issues producing a lot of mucus like cystic fibrosis
-Can also be given for Tylenol toxicity
-Can cause bronchospasm, dizziness, drowsiness, hypotension, or anaphylaxis
pH 7.51
CO2 12
HCO3 26
Respiratory Alkalosis
Which of the following is a Leukotriene Modifier?
A. Albuterol
B. Benadryl
C. Montelukast
D. Guanifenesin
C. Montelukast
Leukotriene modifiers suppress the effects of leukotrienes, thereby reducing inflammation, bronchoconstriction, airway edema, and mucus production. Used for asthma in adults and children.
Name some late signs of Hypoxemia.
Stupor or decrease LOC
Cyanosis
Bradypnea
Bradycardia and dysrhythmias
Low BP
A patient with asthma asks about a Peak Flow Meter. What should the nurse include in the teaching?
What should the nurse teach about preventing fungal infections when using inhaled Beclomethasone?
pH 7.20
CO2 45
HCO3 14
Metabolic Acidosis
Give an example of a Methylxanthine bronchodilator.
Theophylline