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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Flail chest occurs when multiple ribs are fractured in more than one location, creating a free-floating segment of the chest wall. This segment moves paradoxically during respiration, meaning it moves inward during inspiration and outward during expiration, which impairs effective breathing and oxygenation.
B. Paralysis of the chest wall may occur in conditions like spinal cord injuries but is not the defining characteristic of flail chest.
C. While decreased oxygenation can occur with flail chest due to impaired ventilation, the defining feature is the paradoxical movement of the fractured rib segment.
D. Weakness of the diaphragm can impair lung expansion, but this is characteristic of conditions like diaphragmatic paralysis, not flail chest.
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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