A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Anxiety attack

Pneumonia

Pulmonary embolism

Asthma exacerbation

Answer and Explanation

The Correct Answer is C

A. While anxiety can cause rapid breathing and confusion, the patient's clinical presentation (dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation) is more consistent with a serious physical condition, such as a pulmonary embolism, rather than an anxiety attack.

B. Pneumonia could cause dyspnea and confusion, but the rapid onset of symptoms, along with the patient's history of prolonged bed rest and risk factors, suggests a pulmonary embolism rather than pneumonia.

C. Pulmonary embolism (PE) is a life-threatening condition that can occur in patients on prolonged bedrest, especially after a pelvic fracture. The patient’s symptoms of dyspnea, confusion, tachycardia, hypotension, and oxygen desaturation are classic signs of PE. This requires immediate intervention, including anticoagulation and possibly thrombolytic therapy.

D. Asthma exacerbation typically presents with wheezing and difficulty breathing, but it would not typically cause the severe hypotension, confusion, and rapid oxygen desaturation seen in this patient.

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Correct Answer is ["A","B","E"]

Explanation

A. Ipratropium (Atrovent HFA) is an anticholinergic medication that can be used in combination with short-acting beta-agonists like albuterol to help relieve bronchospasm during an acute asthma attack.

B. Albuterol (Proventil HFA) is a short-acting beta-agonist (SABA) that is commonly used as a first-line treatment during an acute asthma attack to rapidly relieve bronchoconstriction and improve airflow.

C. Salmeterol (Serevent Diskus) is a long-acting beta-agonist (LABA) used for long-term asthma control, not for acute exacerbations. LABAs are not effective in quickly relieving symptoms during an acute attack.

D. Montelukast (Singulair) is a leukotriene modifier used for long-term asthma management and prevention. It is not effective in treating acute asthma attacks.

E. Inhaled hypertonic saline can help in acute asthma attacks by increasing mucus clearance and improving respiratory function, especially in patients with severe symptoms.

A. Administer pain medication as prescribed. B. Notify the healthcare provider immediately. C. Reposition the patient to the unaffected side. D. Document the findings and continue to monitor the drain.

Correct Answer is A

Explanation

A. Administering pain medication is the priority action in this scenario. The patient is experiencing significant post-surgical pain, which can impair their ability to breathe deeply and effectively. Addressing pain will improve comfort and facilitate better respiratory effort.

B. Notifying the healthcare provider immediately is not warranted based on the current findings. The amount of drainage (50 mL) is within expected limits for the first hour after surgery, and fluctuation in the water seal chamber indicates the chest tube is functioning properly.

C. Repositioning the patient to the unaffected side may help with comfort but is not the most appropriate action to address the pain or improve respiratory status in this situation.

D. Documenting the findings and continuing to monitor the drain is important but does not address the patient’s immediate need for pain relief.

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A patient on prolonged bedrest following a pelvic fracture becomes dyspneic and confused. Pulse = 135 beats/minute, blood pressure = 90/50 mmHg, respirations = 36/minute, Oxygen saturation starts dropping rapidly. Which of the following conditions should the nurse prepare to treat for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which medications would be most appropriate to administer to a patient experiencing an acute asthma attack? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

Correct Answer is A

Explanation

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