A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on oxygen therapy. Which instruction should the nurse include in the discharge teaching?

Store the oxygen tanks near sources of heat to prevent them from freezing.

Use the oxygen therapy only during periods of activity or exertion.

Adjust the oxygen flow rate to the highest level possible to improve breathing.

Use the oxygen therapy continuously, even during sleep.

Answer and Explanation

The Correct Answer is D

A. Storing oxygen tanks near sources of heat is dangerous. Oxygen should be stored in a cool, dry place away from heat sources and flammable materials to prevent the risk of fire or explosion.

B. Oxygen therapy should not be limited to periods of activity or exertion. For patients with COPD, continuous oxygen therapy is often necessary to maintain adequate oxygen saturation levels, even during sleep.

C. Adjusting the oxygen flow rate to the highest level can be harmful, especially in patients with COPD, as it may suppress their hypoxic drive to breathe. The flow rate should be prescribed and adjusted by the healthcare provider.

D. Continuous use of oxygen therapy, even during sleep, is essential for maintaining adequate oxygen saturation levels in patients with COPD. This helps prevent hypoxemia and ensures the patient receives the necessary oxygen support.

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Correct Answer is C

Explanation

A. Clamping the chest tube near the water seal is not recommended because it can lead to complications such as a tension pneumothorax. The chest tube should remain unclamped unless instructed by the healthcare provider.

B. Repositioning the client may be necessary if the rise in the water seal chamber is due to a physical obstruction or positioning issue. However, this is not the first action to take.

C. A rise in the water seal chamber with inspiration (tidal fluctuation) is a normal finding in a chest tube system. It indicates that the lung is re-expanding and that the pleural space is still connected to the atmosphere. The nurse should continue to monitor the client and the chest tube system for any other changes.

D. Immediate notification of the provider is not necessary unless there are other signs of complications, such as sudden changes in the drainage amount, a lack of fluctuation, or signs of respiratory distress.

A. Administer supplemental oxygen to the client. B. Check the position of the pulse oximeter probe and ensure it is properly attached. C. Assess the client's airway for obstruction. D. Notify the healthcare provider immediately.

Correct Answer is B

Explanation

A. Administering supplemental oxygen is appropriate if the low oxygen saturation is confirmed, but the nurse should first verify the accuracy of the reading to avoid unnecessary interventions.

B. Checking the position of the pulse oximeter probe and ensuring it is properly attached is the first step. Faulty probe placement or technical issues can cause inaccurate readings, so confirming the validity of the drop in SpO2 is essential before taking further action.

C. Assessing the client's airway for obstruction is critical if the low SpO2 is verified and no technical issues are found. However, this step follows confirming the accuracy of the pulse oximetry reading.

D. Notifying the healthcare provider is necessary if the drop in SpO2 is confirmed and persists despite initial nursing interventions, but it is not the first action.

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A patient hospitalized with chronic obstructive pulmonary disease (COPD) is being discharged home on oxygen therapy. Which instruction should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a three-chamber closed chest tube system. Which of the following actions should the nurse take after noticing a rise in the water seal chamber with client inspiration?

Correct Answer is C

Explanation

During assessment of a client on the respiratory unit, the pulse oximetry monitor indicates a drop of SpO2 from 98% to 87% over four hours in a client who previously had normal range oxygen saturation level. Which of the following actions should the nurse perform first?

Correct Answer is B

Explanation

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