A nurse is listening to the lungs of a hospitalized post-surgical patient and notes diminished breath sounds in the right lower lobe. The patient has an elevated temperature and green sputum. These findings could indicate _ because of _.

nosocomial pneumonia; lung tissue atelectasis

lung tissue atelectasis; community-acquired pneumonia

pulmonary edema; right heart failure

pulmonary edema; left heart failure

Answer and Explanation

The Correct Answer is A

A. Nosocomial (hospital-acquired) pneumonia is common in post-surgical patients, particularly those with atelectasis, as diminished ventilation can lead to infection. The green sputum and fever are signs of infection.

B. Lung tissue atelectasis may predispose a patient to pneumonia, but community-acquired pneumonia is less likely in a hospitalized patient, and the green sputum is more indicative of nosocomial infection.

C. Pulmonary edema is associated with fluid in the lungs but does not typically cause green sputum or elevated temperature, which suggest infection.

D. Left heart failure may lead to pulmonary edema but is not associated with green sputum or fever.

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Correct Answer is C

Explanation

A. Bleeding in the brain could cause neurological symptoms but does not directly correlate with the respiratory acidosis indicated by the ABGs.

B. Anxiety typically leads to respiratory alkalosis due to hyperventilation, which does not align with the results showing acidemia.

C. The ABG results indicate a primary respiratory acidosis (low pH and elevated PCO2), which can occur in kidney failure due to the kidneys' inability to excrete acids and manage bicarbonate, leading to an accumulation of CO2.

D. Extreme vomiting is associated with metabolic alkalosis due to loss of gastric acid, which does not explain the acid-base disturbance presented.

A. hypertension; vision test B. left heart failure; b-type natriuretic peptide (BNP) C. aspiration pneumonia; arterial blood gas (ABG) D. chronic bronchitis; peak flow

Correct Answer is D

Explanation

A. Hypertension may contribute to cardiovascular issues, but it does not typically cause cyanosis or clubbing.

B. Left heart failure often leads to symptoms like dyspnea and fluid retention but does not commonly cause clubbing of the fingers.

C. Aspiration pneumonia may cause respiratory symptoms, but clubbing is more associated with chronic hypoxia, seen in conditions like chronic bronchitis.

D. Chronic bronchitis, often seen in chronic obstructive pulmonary disease (COPD), can cause long-term hypoxia, leading to cyanosis and clubbing of the fingers. A peak flow test can assess respiratory function and airflow limitations associated with chronic bronchitis.

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A nurse is listening to the lungs of a hospitalized post-surgical patient and notes diminished breath sounds in the right lower lobe. The patient has an elevated temperature and green sputum. These findings could indicate _____ because of _____.

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A nurse is listening to the lungs of a hospitalized post-surgical patient and notes diminished breath sounds in the right lower lobe. The patient has an elevated temperature and green sputum. These findings could indicate _ because of _.