A client with laryngitis related to influenza is experiencing difficulty speaking and persistent cough. What nursing advice should be given?
Administer antitussives to suppress coughing completely.
Prescribe antibiotics to prevent progression of the infection.
Encourage voice rest and hydration to promote recovery.
Advise frequent use of decongestants to reduce throat inflammation.
The Correct Answer is C
A. Administer antitussives to suppress coughing completely: Coughing is a protective reflex needed to clear secretions from the respiratory tract. Completely suppressing it can lead to mucus accumulation and secondary pneumonia. In viral infections, the cough should only be managed if it is non-productive and prevents sleep or causes exhaustion.
B. Prescribe antibiotics to prevent progression of the infection: Laryngitis caused by influenza is viral in origin, making antibiotics biologically ineffective. Prescribing them "just in case" is against evidence-based practice and leads to the development of resistant bacterial strains. Antibiotics provide no relief for the inflammation or viral load associated with influenza.
C. Encourage voice rest and hydration to promote recovery: Resting the vocal cords reduces mechanical irritation and allows the laryngeal mucosa to heal. Hydration keeps the mucosal linings moist and helps thin any secretions, making them easier to clear. This is the standard, evidence-based supportive care for viral laryngitis.
D. Advise frequent use of decongestants to reduce throat inflammation: Decongestants target the nasal passages by causing vasoconstriction and have no direct effect on the inflammation of the larynx. They can also have a drying effect on the throat, which may worsen the irritation and cough. They are not an appropriate treatment for the primary symptoms of laryngitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Asthma:While asthma causes wheezing due to bronchoconstriction, it does not typically cause a global decrease in breath sounds unless the attack is severe and air movement is minimal. In many cases of asthma, breath sounds are audible but adventitious. Decreased sounds suggest a more significant barrier to air transmission.
B. Normal lung function:Normal lung function is characterized by clear, vesicular breath sounds in the periphery and bronchial sounds over the larger airways. Decreased or absent breath sounds are always an abnormal finding that requires further investigation. They indicate an interruption in the normal transmission of sound through the lung tissue.
C. Bronchitis:Bronchitis typically manifests as loud, coarse rhonchi or wheezes caused by mucus and inflammation in the large airways. Breath sounds are usually present but distorted by the adventitious noises. It does not typically result in the diminished intensity of sound associated with "decreased" breath sounds.
D. Pleural effusion:The accumulation of fluid in the pleural space acts as a physical barrier that dampens the transmission of sound from the lungs to the chest wall. This results in significantly diminished or absent breath sounds over the area of the effusion. It is a classic clinical finding for this pathological state.
Correct Answer is C
Explanation
A. Encouraging deep breathing exercises:While deep breathing is generally helpful, it may be difficult for a patient with emphysema who suffers from air trapping. Without proper positioning, these exercises may not be enough to overcome the mechanical disadvantage of a flattened diaphragm. It is a secondary supportive measure for pulmonary hygiene.
B. Restricting fluid intake:Fluid restriction is not indicated for emphysema unless the patient has developed secondary right-sided heart failure. In fact, adequate hydration is usually encouraged to keep secretions thin and easy to expectorate. Restricting fluids without a specific cause could lead to thickened mucus and worsening obstruction.
C. Positioning the patient in high Fowler's:Elevating the head of the bed to 60 to 90 degrees allows for maximum diaphragmatic excursion and chest expansion. This position uses gravity to pull the abdominal contents downward, reducing pressure on the lungs and improving the efficiency of gas exchange. It is the most effective immediate non-pharmacological intervention.
D. Administering bronchodilators:These medications help open the airways but may not be enough to resolve acute hypoxemia if the patient's positioning is poor. While they are a vital part of the pharmacological regimen, they work best when combined with optimal positioning. Positioning provides an immediate mechanical advantage for ventilation.
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