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 C

Explanation

A. Tonsillitis typically presents with sore throat, difficulty swallowing, and inflamed tonsils, but it does not involve ear pain or tympanic membrane abnormalities.
B. Laryngitis presents with hoarseness or loss of voice due to inflammation of the larynx, not ear pain or tympanic membrane abnormalities.

C. Acute otitis media commonly presents with ear pain, dull tympanic membrane, and may be preceded by an upper respiratory tract infection. Tender, enlarged postauricular lymph nodes can also be present.
D. Allergic rhinitis typically presents with nasal congestion, sneezing, and itchy, watery eyes, but not with ear pain or tympanic membrane abnormalities.

A. Start George on antiepileptic drugs for neuropathic pain B. Initiate immediate dialysis to manage neuropathy C. Administer a bolus of rapid-acting insulin D. Teach George about foot care and daily foot inspections

Correct Answer is D

Explanation

A. While antiepileptic drugs are sometimes used to manage neuropathic pain, the priority in George's case is preventing complications related to diabetic neuropathy.
B. Dialysis is not indicated for neuropathy management.

C. While managing blood glucose levels is important in diabetes management, immediate insulin administration may not be necessary unless George is experiencing hyperglycemic crisis.
D. This is the priority intervention to prevent complications such as diabetic foot ulcers and 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

Correct Answer is C

Explanation

George, 65, has a 10-year history of diabetes mellitus. He complains of tingling sensations and numbness in his feet. His HbA1c is 9%, and a monofilament test reveals a loss of sensation. Which of the following interventions should be prioritized?

Correct Answer is D

Explanation

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