Case Study (Pneumonia-Adult)

Exhibits

Which intervention is most appropriate to improve the patient's oxygenation?

A. Have the client lean over an over-the-bed table:This position is sometimes used during posterior thoracic examination or for percussing lung fields, but it is not standard for routine chest auscultation. Most chest sounds can be assessed with the client sitting upright or lying down.

B. Use the bell of the stethoscope held lightly against the chest:The bell is best for detecting low-pitched sounds like some heart murmurs, not respiratory sounds. Lung sounds are higher-pitched and require use of the diaphragm for accurate auscultation.

C. Use the diaphragm of the stethoscope held firmly against the chest:This is the correct technique for auscultating lung sounds, which are typically high-pitched. Holding the diaphragm firmly ensures clear transmission of breath sounds such as crackles, wheezes, or rhonchi.

D. Instruct the client to take deep, rapid breaths through their nose:Deep breathing is appropriate during auscultation, but it should be done through the mouth. Breathing through the nose may reduce air entry and obscure abnormal sounds, making it harder to detect lung pathology.

A. “I will rest my hand over my abdomen to create resistance.” This technique is used for diaphragmatic breathing exercises, not incentive spirometry. It does not help assess or improve lung expansion, which is the primary goal of using the incentive spirometer.

B. “I will lie on my back with my knees bent.” While lying down may be appropriate for some breathing exercises, the incentive spirometer is best used in a sitting or upright position. Sitting allows for maximal lung expansion and facilitates more effective use of the device.

C. “I will place the adapter on my finger to read my blood oxygen saturation level.” This describes the use of a pulse oximeter, not an incentive spirometer. The spirometer measures inspiratory volume, while pulse oximetry is used to monitor oxygen saturation.

D. "I will take in a deep breath and hold it before exhaling." The client should inhale slowly and deeply through the mouthpiece, hold the breath for several seconds to promote alveolar inflation, then exhale. This process helps prevent atelectasis and promotes lung expansion.