After change of shift, the nurse has the following patients on her assignment. Which one should she see first?
A 50-year-old with COPD and a Spo2 of 90%
A 72-year-old with pneumonia who needs his antibiotic
A 37-year-old with asthma who reported that he is still having shortness of breath after using his inhaler
A68-year-old on a CPAP who needs a sputum specimen sent to the lab
The Correct Answer is C
C. Persistent shortness of breath after using an inhaler could indicate an inadequate response to treatment or worsening asthma exacerbation. The nurse should therefore see this patient first.
A. In COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable. In the treatment of exacerbations of chronic obstructive pulmonary disease (COPD), oxygen should be titrated to achieve a target oxygen saturation range of 88-92%. This results in a greater than twofold reduction in mortality, compared with the routine administration of high-concentration oxygen therapy.
B. Administering antibiotics can be prioritized, but it may not require immediate attention compared to addressing acute respiratory distress or hypoxemia.
D. Collecting a sputum specimen for laboratory analysis is important for diagnosing and managing respiratory infections, but it may not be as time-sensitive as addressing acute respiratory distress or hypoxemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This range is generally considered acceptable for most patients with COPD. It provides a balance between ensuring adequate oxygenation while avoiding the risk of oxygen toxicity. Oxygen saturation levels within this range can help alleviate symptoms of hypoxemia without causing hyperoxia.
B. Oxygen saturation levels below 90% can lead to significant hypoxemia and exacerbate respiratory distress in individuals with COPD. Maintaining oxygen saturation levels above 90% is typically recommended to prevent complications associated with hypoxemia.
C. This range is appropriate for some patients but it may not be ideal for all patients with COPD. Oxygen saturation levels at the higher end of this range (e.g., 100%) can increase the risk of oxygen toxicity in patients with COPD who retain carbon dioxide (CO2) due to their chronic respiratory condition.
D. Oxygen saturation levels within this range help to balance the need for oxygen supplementation with the risk of hyperoxia and oxygen toxicity. However, individual patient factors, such as the severity of COPD, baseline oxygen saturation levels, and comorbidities, should be considered when determining the target range for oxygen saturation.
Correct Answer is ["B","D","E"]
Explanation
B. Bronchodilators are medications commonly used to relieve bronchospasm and improve airflow in patients with COPD. They work by relaxing the muscles around the airways, making it easier to breathe. Providing bronchodilators as prescribed can help alleviate difficulty breathing and improve the patient's respiratory function.
D. Smoking cessation is essential for patients with COPD as smoking is the leading cause of the disease and can exacerbate respiratory symptoms. Quitting smoking can slow the progression of COPD, reduce the frequency and severity of exacerbations, and improve overall lung function.
E. Corticosteroids are anti-inflammatory medications commonly used to reduce airway inflammation and control exacerbations in patients with COPD. They can help improve breathing and reduce the severity of respiratory symptoms during acute exacerbations.
A. Offering small frequent meals can help reduce the sensation of fullness and bloating, which can sometimes occur in patients with COPD due to increased abdominal pressure from compromised respiratory function. However, this is not specific to COPD.
C. Weaning from oxygen should be done cautiously and under the guidance of healthcare providers but not in the state of difficulty in breathing. Oxygen therapy is often necessary for patients with COPD who experience difficulty breathing, especially during acute exacerbations. Therefore, weaning from oxygen may be appropriate once the patient's respiratory status stabilizes and oxygen saturation levels improve.
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