A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

Asking the provider to repeat another radiograph of the chest

Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client

Requesting the pharmacy to dispense 10 mL of dextromethorphan PO

Instructing respiratory therapy to administer a PRN albuterol aerosol

Answer and Explanation

The Correct Answer is D

A. Asking the provider to repeat another radiograph of the chest.

This option is not the most appropriate action in this scenario. While a chest radiograph may be useful in certain situations to assess for complications such as pneumothorax or pneumonia, it is not typically the first intervention for an asthma exacerbation with increased wheezing and decreased oxygen saturation. In this acute situation, the priority is to provide immediate treatment to alleviate the client's symptoms and improve oxygenation.

B. Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client.

While maintaining adequate oxygenation is important, especially in a client with asthma exacerbation, it is not the first-line intervention in this scenario. Oxygen supplementation may be necessary, but the priority is to address the underlying bronchospasm causing the decreased oxygen saturation. Therefore, this option may be considered after initiating appropriate bronchodilator therapy.

C. Requesting the pharmacy to dispense 10 mL of dextromethorphan PO.

This option is not appropriate for managing an asthma exacerbation. Dextromethorphan is a cough suppressant and does not address the underlying bronchospasm characteristic of asthma exacerbations. In fact, suppressing cough may hinder the clearance of mucus and exacerbate respiratory distress. Therefore, this intervention is not indicated and may delay appropriate treatment.

D. Instructing respiratory therapy to administer a PRN albuterol aerosol.

This is the correct action in this scenario. Albuterol is a short-acting bronchodilator commonly used to relieve bronchospasm and improve airflow in clients experiencing asthma exacerbations. Administering albuterol via aerosolized inhalation helps to quickly deliver the medication directly to the airways, providing rapid relief of symptoms such as wheezing and improving oxygenation. Therefore, instructing respiratory therapy to administer a PRN albuterol aerosol is the most appropriate intervention to address the client's acute symptoms.

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Correct Answer is B

Explanation

A. The spacer increases the amount of medication delivered to the oropharynx.

Spacers are designed to minimize the amount of medication deposited in the oropharynx (back of the throat) and reduce the risk of side effects such as oral thrush or hoarseness. The main purpose of using a spacer is to optimize the delivery of medication to the lungs.

B. The spacer increases the amount of medication delivered to the lungs.

When reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma, the nurse should include the information that the spacer increases the amount of medication delivered to the lungs. Spacers help improve the delivery of medication from the MDI to the lungs by reducing the need for coordination between actuation of the MDI and inhalation. They also slow down the speed of the aerosolized medication particles, allowing more time for them to be inhaled into the lungs effectively.

C. Inhale rapidly when using the spacer with the MDI.

Inhaling rapidly may lead to improper inhalation technique and reduce the effectiveness of medication delivery to the lungs. Instead, the child should be instructed to inhale slowly and deeply to ensure that the medication reaches the lower airways.

D. Cover exhalation slots of the spacer with lips when inhaling.

Covering the exhalation slots of the spacer with lips during inhalation is not recommended. These slots are designed to allow the child to exhale freely and prevent buildup of pressure within the spacer. Encouraging the child to exhale into the spacer would hinder proper inhalation technique and could lead to decreased medication delivery to the lungs.

A. Offer small frequent meals B. Encourage extra liquids with meals C. Assist the patient to exercise before meals D. Supply information about nutrition

Correct Answer is A

Explanation

A. Offer small frequent meals

Offering small, frequent meals is beneficial for patients with COPD because it helps overcome the challenges associated with dyspnea and fatigue. Large meals can cause discomfort and increase the effort required for breathing, which can exacerbate respiratory symptoms. By providing smaller, more manageable portions of food throughout the day, patients with COPD can maintain their energy levels and meet their nutritional needs without experiencing excessive respiratory distress.

B. Encourage extra liquids with meals

Encouraging extra liquids with meals can help prevent dehydration and thin respiratory secretions, making it easier for patients with COPD to manage their respiratory symptoms. However, excessive fluid intake can also lead to feelings of fullness and discomfort, especially in patients with compromised lung function. Therefore, while it's important to encourage adequate hydration, particularly during meals, it's also essential to balance fluid intake to avoid exacerbating respiratory symptoms.

C. Assist the patient to exercise before meals

While regular exercise is beneficial for overall health and can help improve respiratory function in patients with COPD, exercising immediately before meals may not be practical or advisable for all patients. Patients with COPD may experience fatigue and dyspnea during physical activity, which can affect their ability to eat and digest food effectively. Additionally, exercising before meals may increase energy expenditure and exacerbate respiratory symptoms, making it more challenging for patients to consume an adequate amount of nutrients. Instead, patients with COPD may benefit from engaging in light physical activity or respiratory exercises at a different time of day to improve their respiratory function and overall well-being.

D. Supply information about nutrition

Providing information about nutrition is essential for patients with COPD to help them make healthy dietary choices and manage their condition effectively. However, simply supplying information may not be sufficient to enhance the nutritional status of patients with COPD. It's important to offer practical guidance and support, such as meal planning tips, dietary modifications, and strategies for overcoming barriers to healthy eating. Additionally, individualized dietary counseling from a registered dietitian can be beneficial for patients with COPD to address specific nutritional needs and preferences.

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A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?

Correct Answer is B

Explanation

What nursing intervention enhances the nutritional status of a patient with COPD?

Correct Answer is A

Explanation

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Which of the following is true regarding the physiology of an open pneumothorax?

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