A patient with chronic obstructive pulmonary disease (COPD) presents with dyspnea and wheezing. What is the most appropriate initial nursing intervention to manage these symptoms?

Provide oral hydration

Teach the patient pursed-lip breathing

Initiate corticosteroid therapy

Administer a short-acting beta-agonist (SABA)

Answer and Explanation

The Correct Answer is D

A. Oral hydration is important for overall health and to thin secretions, but it is not the immediate intervention to address dyspnea and wheezing in COPD.

B. Pursed-lip breathing is a helpful technique for managing chronic symptoms of COPD and improving airflow, but it is not the first step in managing acute symptoms like dyspnea and wheezing.

C. Corticosteroid therapy may be part of the treatment for COPD exacerbations, but it is not the initial intervention for acute symptoms. It is typically used after bronchodilators like SABA have been administered.

D. A short-acting beta-agonist (SABA), such as albuterol, is the first-line treatment for acute dyspnea and wheezing in COPD. It works by relaxing the bronchial muscles, opening the airways, and improving airflow.

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Correct Answer is A

Explanation

A. If there is no fluctuation in the water seal compartment, the first action should be to check for kinks, obstructions, or other issues in the tubing that might block air or fluid movement. Fluctuation (tidaling) is expected during respiration, and its absence may indicate a problem with the system or that the lung has fully re-expanded.

B. Notifying the healthcare provider immediately is not the first step. The nurse should first assess the chest tube system to determine if there is an issue that can be resolved without medical intervention.

C. Increasing the suction pressure on the chest tube is not appropriate without first identifying the cause of the lack of fluctuation. Adjusting suction may not address the underlying problem.

D. Continuing to monitor and reassess in 1 hour delays addressing the potential issue. Immediate assessment of the chest tube system is necessary to ensure proper functioning.

A. Continuous bubbling within the water seal chamber B. Fluctuation of the fluid level within the water seal chamber C. Absence of fluid in the drainage tubing D. Equal amounts of fluid drainage in each collection chamber

Correct Answer is B

Explanation

A. Continuous bubbling within the water seal chamber indicates an air leak in the system, which is not a sign of proper chest tube functioning. The nurse should investigate and address any air leaks promptly.

B. Fluctuation of the fluid level within the water seal chamber, also known as tidaling, indicates that the chest tube is functioning properly. Tidaling reflects changes in intrapleural pressure during respiration and confirms that the system is intact.

C. Absence of fluid in the drainage tubing is not an indicator of proper functioning. Depending on the client’s condition, there may or may not be fluid in the tubing. However, the system should always be assessed for patency and appropriate drainage.

D. Equal amounts of fluid drainage in each collection chamber are not expected or required. The amount of drainage depends on the client’s condition and does not indicate the functionality of the chest tube system.

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A patient with chronic obstructive pulmonary disease (COPD) presents with dyspnea and wheezing. What is the most appropriate initial nursing intervention to manage these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client had a right-sided chest tube inserted two hours ago for pneumothorax. Which action should the nurse implement if there is no fluctuation in the water seal compartment?

Correct Answer is A

Explanation

The nurse is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly?

Correct Answer is B

Explanation

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?

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