A patient came to the walk-in clinic with extremely labored breathing and a history of asthma that is unresponsive to prescribed inhalers or medications. What would you do first?
Call 911 and report that the patient has probable status asthmaticus.
Obtain the equipment and prepare the patient for intubation.
Establish IV access to give emergency medication.
Place the patient in a high Fowler's position and start oxygen therapy.
The Correct Answer is D
A. While status asthmaticus is a severe, life-threatening asthma exacerbation, the first step is to stabilize the patient by improving oxygenation and relieving airway obstruction, not immediately calling 911 unless the situation worsens.
B. Intubation is not the first step unless the patient's respiratory status continues to deteriorate despite initial interventions. The focus should be on improving oxygenation and managing the airway.
C. Establishing IV access and administering emergency medications, such as corticosteroids or bronchodilators, may be necessary, but the first priority is to improve the patient's breathing and oxygenation.
D. Placing the patient in a high Fowler's position helps to open the airways and facilitate breathing. Starting oxygen therapy is essential to support oxygenation in a patient with labored breathing. This should be the first intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dyspnea is the term used to describe the sensation of shortness of breath or difficulty breathing. It is the most appropriate term to document when a client reports feeling unable to get enough air.
B. Aspiration refers to the inhalation of food, liquid, or foreign material into the airway, which may lead to choking or aspiration pneumonia, not a sensation of shortness of breath.
C. Hemoptysis is the coughing up of blood, which is not described in the client's report.
D. Orthopnea is shortness of breath that occurs when lying flat and is typically seen in conditions like heart failure. The client’s description does not specify that the symptoms occur while lying down.
Correct Answer is A
Explanation
A. Arterial blood gas (ABG) analysis is the most accurate method for distinguishing between hypoxemia (low oxygen levels in the blood) and hypercapnia (elevated carbon dioxide levels). ABG testing measures both the partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), providing a clear distinction between the two conditions.
B. While observing for signs and symptoms is useful, it is not specific enough to distinguish between hypoxemia and hypercapnia, as both conditions may present with similar symptoms like shortness of breath or confusion.
C. Measuring oxygen saturation with a pulse oximeter can detect hypoxemia but does not provide information about carbon dioxide levels, so it cannot distinguish between hypoxemia and hypercapnia.
D. Pulmonary function testing assesses lung volumes and airflow but does not directly measure oxygen or carbon dioxide levels, making it less effective for distinguishing between hypoxemia and hypercapnia.
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