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?

A. Administer IV morphine.

IV morphine may be indicated to relieve pain and anxiety associated with a pulmonary embolism. However, it is not the priority intervention compared to addressing the client's respiratory distress and hypoxemia with oxygen therapy.

B. Begin oxygen therapy.

The priority intervention for a client who develops a pulmonary embolism is to begin oxygen therapy. Pulmonary embolism (PE) is a life-threatening condition characterized by a blockage in one or more of the pulmonary arteries, usually due to a blood clot. This blockage can lead to impaired gas exchange and decreased oxygenation of the blood, resulting in hypoxemia (low blood oxygen levels) and potentially leading to respiratory failure. Administering oxygen therapy promptly helps to improve oxygenation and support vital organ function. Therefore, it is the priority intervention to address the immediate respiratory distress associated with a pulmonary embolism.

C. Start an IV infusion of lactated Ringer's.

Intravenous fluid administration may be necessary to maintain hemodynamic stability and support perfusion in a client with a pulmonary embolism. However, it is not the priority intervention compared to addressing the client's respiratory distress and hypoxemia with oxygen therapy.

D. Initiate cardiac monitoring.

Cardiac monitoring is important to assess for signs of cardiac compromise or dysrhythmias associated with a pulmonary embolism. However, it is not the priority intervention compared to addressing the client's respiratory distress and hypoxemia with oxygen therapy.

A. Spoon nails

Spoon nails, also known as koilonychia, refer to a concave or spoon-shaped deformity of the nails. This finding is associated with conditions such as iron deficiency anemia or certain systemic diseases, but it is not specifically associated with COPD.

B. Peripheral edema

Peripheral edema, or swelling of the extremities, is not a typical finding in COPD. It may occur in conditions such as heart failure, liver disease, or kidney disease, but it is not directly related to COPD unless there are comorbid conditions contributing to fluid retention.

C. Pleural friction rub

Pleural friction rub refers to a creaking or grating sound heard on auscultation of the lungs, typically during inspiration and expiration. It occurs when the inflamed pleural surfaces rub against each other. While pleural effusion (accumulation of fluid in the pleural space) may occur as a complication of COPD, pleural friction rub is not a typical finding in uncomplicated COPD.

D. Barrel chest

Barrel chest is a common finding in clients with COPD. It refers to an increased anterior-posterior diameter of the chest, giving it a rounded appearance similar to that of a barrel. This occurs due to hyperinflation of the lungs, which is characteristic of COPD, particularly in advanced stages. The hyperinflation leads to chronic air trapping and increased residual volume in the lungs, causing the chest to become enlarged and rounded.