Linda, a 70-year-old woman with COPD, has arterial blood gases that show a pH of 7.35, PaCO2 of 55, and Pa02 of 60. She is currently on 2 liters of oxygen via a nasal -cannula. Which of the following interventions are appropriate for Linda? Select all that apply

Increase oxygen supply to 4 liters per minute via a nasal cannula.

Initiate non-invasive positive pressure ventilation.

Teach diaphragmatic breathing techniques.

Administer a short-acting bronchodilator.

Reassess arterial blood gases in 6 hours.

Answer and Explanation

Correct Answer : A,C,D,E

A.   Increasing oxygen supply to 4 liters per minute via a nasal cannula is not appropriate, as it can cause carbon dioxide retention and respiratory acidosis in COPD patients.
B.   Initiating non-invasive positive pressure ventilation is not appropriate, as it can cause barotrauma and pneumothorax in COPD patients.

C.   Teaching diaphragmatic breathing techniques can help Linda improve her ventilation and oxygenation by using the diaphragm more effectively.
D.   Bronchodilators can help relieve bronchospasm and improve ventilation in COPD exacerbations.
E.   Serial monitoring of arterial blood gases is essential to evaluate the effectiveness of interventions and guide further management.

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Correct Answer is D

Explanation

A. While assessing sternal tenderness is relevant, skin abrasions may not directly indicate complications from the chest contusion.

B. Sternal tenderness can indicate underlying injuries but is not the priority compared to auscultation of the lung zones, and measuring oxygen saturation levels is crucial for assessing respiratory function and detecting potential complications such as respiratory distress or hypoxemia.
C. Blood pressure measurement and observation for signs of localized infection are important assessments but may not be directly related to complications from a chest contusion.
D. This is because a contusion across the chest from the seatbelt can cause rib fractures, pneumothorax, hemothorax, or pulmonary contusion, which can impair gas exchange and oxygenation. Measuring oxygen saturation levels and auscultating lung sounds can help detect these complications and guide appropriate interventions.

A. Reduction in saliva production B. Thickening of the skin C. Weakening of the periosteum D. Reduced ciliary action in the respiratory tract

Correct Answer is D

Explanation

A. Reduction in saliva production is not directly related to the immune system; it's more associated with oral health.
B. Thickening of the skin is a normal part of aging but is not directly related to the immune system.
C. Weakening of the periosteum refers to the outer layer of bone, and while it can occur with aging, it's not directly relevant to the immune system.
D. Reduced ciliary action in the respiratory tract is a common age-related change that can compromise the body's ability to clear pathogens and debris from the respiratory system, thus increasing susceptibility to respiratory infections.

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Linda, a 70-year-old woman with COPD, has arterial blood gases that show a pH of 7.35, PaCO2 of 55, and Pa02 of 60. She is currently on 2 liters of oxygen via a nasal -cannula. Which of the following interventions are appropriate for Linda? Select all that apply

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Naxlex Comprehensive Predictor Exams

John, a 35-year-old male involved in a motor vehicle accident, presents with a contusion across his chest from the seatbelt. Which two combined assessments should the nurse prioritize to detect potential complications?

Correct Answer is D

Explanation

Sarah, a 75-year-old woman with a history of COPD, has recently been experiencing frequent respiratory infections. As the nurse teaches her about the impact of aging on the immune system, which change should be emphasized?

Correct Answer is D

Explanation

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