A nurse is caring for a client who is dying and having Cheyne-Stokes respirations. Which of the following respiratory findings should the nurse expect?

Irregular respirations with frequent periods of apnea

Irregular respirations greater than 20/min

Regular, rapid, shallow respirations

Regular respirations fewer than 12/min

Answer and Explanation

The Correct Answer is A

Cheyne-Stokes respirations are an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes. This type of breathing may occur in people who are dying due to heart failure, stroke, brain injury or other causes. The nurse should expect to observe irregular respirations with frequent periods of apnea in the client who is dying and having Cheyne-Stokes respirations.

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Correct Answer is D

Explanation

This intervention can help promote sleep by increasing serotonin levels in the brain, which have a calming effect. The other interventions are not appropriate for a client who has insomnia.

A. Use sterile gloves to provide perineal care. B. Cleanse hands with an alcohol-based hand rub before client contact C. Have the client apply a mask when children are visiting D. Place the client in a semiprivate room

Correct Answer is B

Explanation

Cleanse hands with an alcohol-based hand rub before client contact. This action reduces the risk of transmitting microorganisms to the client who has a weakened immune system.

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A nurse is caring for a client who is dying and having Cheyne-Stokes respirations. Which of the following respiratory findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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