A 75-year-old patient with emphysema states "Every year I end up getting admitted to the ICU because of bad breathing problems. I'm really trying to stay out of there this year. Which points are appropriate for the nurse to include in a teaching session? (SELECT ALL THAT APPLY)

Make sure you are rinsing & drying your inhaler holders daily.

Have you contacted social work about long-term care placement?

Are you currently getting the influenza vaccine yearly?

Do you have access to nutritious meals each day?

Limit your daytime fluid intake if you're using the bathroom too much

Answer and Explanation

Correct Answer : A,C,D

A. Make sure you are rinsing & drying your inhaler holders daily – Proper cleaning of inhaler devices is essential to prevent bacterial contamination, which can lead to respiratory infections and exacerbations of emphysema. This is an important point in client education.

B. Have you contacted social work about long-term care placement? This is not appropriate unless the patient has expressed interest in or a need for long-term care. The patient is seeking ways to stay out of the ICU, not leave home for institutional care, so this response is not supportive or relevant to the patient's current goal.

C. Are you currently getting the influenza vaccine yearly? Annual influenza vaccination is strongly recommended for patients with chronic respiratory diseases such as emphysema. It helps reduce the risk of flu-related complications and hospitalizations.

D. Do you have access to nutritious meals each day?. Good nutrition supports immune function and overall health. Malnutrition can weaken respiratory muscles and the immune system, increasing the risk of exacerbations.

E. Limit your daytime fluid intake if you're using the bathroom too much. Fluid restriction is not routinely recommended for patients with emphysema unless there’s another condition like heart failure requiring it. In fact, adequate hydration can help thin secretions, making them easier to clear from the lungs. Restricting fluids without cause could be harmful.

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Correct Answer is B

Explanation

A. Arrange for social service consult for assistance with medication purchase: While this is important for ensuring the patient has access to necessary medications, it is not directly related to fall prevention. Medication access is a separate concern and does not address the immediate environmental or physical aspects contributing to falls in a patient with Parkinson's Disease.

B. Remove any obstacles such as area rugs, wires and unnecessary decorations: Environmental safety is crucial in fall prevention for patients with Parkinson's Disease. Due to motor symptoms like tremors, rigidity, and bradykinesia, individuals with PD are at an increased risk of tripping and falling. Removing obstacles in the home environment helps create a safer space and reduces the risk of falls.

C. Have the patient seen by a nursing assistant 3 times a week for hygiene assistance: While hygiene assistance may be helpful, this does not directly address fall prevention. Regular nursing or caregiver assistance can help with activities of daily living, but the most effective fall prevention strategy would be to modify the environment and address physical factors directly.

D. Refer the client to a nutritionist to address dietary measures: A nutritionist can be helpful for managing the patient's overall health, but diet does not directly prevent falls in Parkinson's Disease. Fall prevention strategies focus more on environmental changes, physical safety, and managing motor symptoms.

A. Insert an oral airway to prevent the client from biting the endotracheal tube B. Suction the patient and reset the ventilator alarm C. Disconnect the client from the ventilator and use a manual bag-valve mask D. Notify the respiratory therapist and health care provider

Correct Answer is C

Explanation

A. Inserting an oral airway may be appropriate if the client is biting the endotracheal tube, but in this scenario, the cause of the low-pressure alarm is unknown and could be due to disconnection or a leak — a more urgent issue requiring immediate action.
B. Suctioning and resetting the alarm could delay appropriate ventilation if the issue is a disconnection or leak; it’s not the priority intervention in an unclear emergency.
C. When the source of a low-pressure alarm (which often indicates a leak or disconnection) cannot be identified and the client’s ventilation status is in question, the nurse should immediately disconnect the client from the ventilator and manually ventilate with a bag-valve mask to ensure oxygenation until the issue is resolved.
D. Notifying the respiratory therapist and provider is appropriate after immediate interventions are performed to maintain the patient’s airway and oxygenation.

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A 75-year-old patient with emphysema states "Every year I end up getting admitted to the ICU because of bad breathing problems. I'm really trying to stay out of there this year. Which points are appropriate for the nurse to include in a teaching session? (SELECT ALL THAT APPLY)

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Naxlex Comprehensive Predictor Exams

To achieve the outcome of fall prevention at home in the patient diagnosed with Parkinson's Disease (PD), which intervention would the nurse include in the plan of care?

Correct Answer is B

Explanation

The nurse is caring for a client receiving mechanical ventilation. The nurse hears the low-pressure alarm sound. After checking the client and ventilator, the nurse cannot determine the source of the alarm. What should the nurse do next?

Correct Answer is C

Explanation

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