A patient with a history of asthma enters the Emergency department with severe dyspnea, accessory muscle involvement, neck vein distention, and severe inspiratory/expiratory wheezing. The nurse should prepare to assist the physician with which procedure if the patient does not respond to initial interventions?
Emergency needle thoracentesis
Emergency intubation
Emergency pleurodesis
Emergency chest tube insertion
The Correct Answer is B
A. Needle thoracentesis is typically performed in cases of pneumothorax or pleural effusion, not asthma exacerbation. The symptoms described do not indicate a pleural space issue that would require thoracentesis.
B. Emergency intubation may be necessary if the asthma exacerbation is severe and unresponsive to initial interventions such as bronchodilators, corticosteroids, and oxygen therapy. The patient's symptoms of severe dyspnea, accessory muscle use, and wheezing suggest respiratory distress, and intubation may be required to secure the airway and assist with ventilation.
C. Pleurodesis is a procedure used to treat recurrent pleural effusions, not asthma exacerbations. It involves the obliteration of the pleural space, which is not relevant to the current situation.
D. Chest tube insertion is typically performed for pneumothorax or other issues involving the pleural space, not for asthma exacerbation. The described symptoms do not suggest the need for a chest tube.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The presence of epithelial cells in urinary casts is indicative of acute tubular necrosis (ATN), a condition where the tubular cells in the kidneys are damaged, often due to ischemia or nephrotoxic substances. These damaged cells shed into the urine, forming casts.
B. Glomerulonephritis is characterized by inflammation of the glomeruli and typically leads to hematuria and proteinuria, but it is not specifically associated with epithelial cells in casts.
C. Urinary tract infections (UTIs) usually cause bacteriuria, pyuria, and sometimes hematuria, but not epithelial cell casts.
D. Pyelonephritis is an infection of the kidneys that can cause white blood cell casts and bacteria in the urine, but it is not typically associated with epithelial cell casts.
Correct Answer is C
Explanation
A. Cystine stones are rare and occur due to a genetic disorder called cystinuria. They are not the most common type of renal calculi.
B. Uric acid stones are also relatively common, especially in individuals with gout or those with high levels of uric acid in the urine. However, calcium oxalate is more common.
C. Calcium oxalate is the most common type of renal calculi, accounting for about 70-80% of kidney stones. These stones form when calcium combines with oxalate in the urine.
D. Struvite stones are associated with urinary tract infections caused by urease-producing bacteria. They are less common than calcium oxalate stones.
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