The nurse has applied a client problem of ineffective gas exchange for a client diagnosed with chronic bronchitis. Which intervention would the nurse include in the plan of care?

Administer oxygen per prescriber’s order to keep SpO2 greater than 96%.

Place patient in Sims position to assist with airway clearance.

Assess client use of a peak expiratory flow rate meter.

Assist with coughing and deep breathing at least every 2 hours while awake.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Administering oxygen per the prescriber’s order to keep SpO2 greater than 96% is not typically recommended for clients with chronic bronchitis. High levels of oxygen can suppress the respiratory drive in clients with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis. The target SpO2 for these clients is usually between 88% and 92%.

Choice B reason:

Placing the patient in the Sims position is not the most effective position for airway clearance. The Fowler’s or semi-Fowler’s position is generally preferred as it promotes better lung expansion and facilitates easier breathing.

Choice C reason:

Assessing the client’s use of a peak expiratory flow rate meter is important for monitoring the severity of bronchospasm and airflow obstruction. However, it is not a direct intervention for improving gas exchange.

Choice D reason:

Assisting with coughing and deep breathing at least every 2 hours while awake is an effective intervention for clients with chronic bronchitis. This helps to mobilize secretions, improve ventilation, and enhance gas exchange. Regular coughing and deep breathing exercises can prevent atelectasis and reduce the risk of respiratory infections.

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Correct Answer is A

Explanation

Choice A reason:

Sitting upright is the best position for a respiratory assessment. This position allows for optimal lung expansion and makes it easier to auscultate breath sounds accurately. It also helps in observing the client’s breathing pattern and effort.

Choice B reason:

Semi-Fowler’s position, where the head of the bed is elevated to 30-45 degrees, is often used for clients with respiratory issues to promote lung expansion and reduce the risk of aspiration. However, it is not as effective as the sitting upright position for a thorough respiratory assessment.

Choice C reason:

The supine position, where the client lies flat on their back, is not ideal for a respiratory assessment. This position can limit lung expansion and make it more difficult to hear breath sounds clearly.

Choice D reason:

The side-lying position is also not suitable for a respiratory assessment. This position can cause uneven lung expansion and make it challenging to assess both lungs accurately.

A. Exercise B. Pollen C. Animal dander D. Emotional stress E. Recent travel abroad

Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason:

Exercise is a well-known trigger for asthma, particularly exercise-induced bronchoconstriction (EIB). During physical activity, especially in cold or dry air, the airways can narrow, leading to symptoms such as shortness of breath, wheezing, and coughing. Proper management and pre-exercise medication can help mitigate these effects.

Choice B reason:

Pollen is a common allergen that can trigger asthma symptoms. Pollen from trees, grasses, and weeds can cause allergic reactions that lead to asthma exacerbations. Seasonal variations in pollen levels can significantly impact individuals with asthma, making it important to monitor pollen counts and take preventive measures.

Choice C reason:

Animal dander, which consists of tiny flakes of skin shed by cats, dogs, and other animals, is a frequent asthma trigger. Proteins found in the dander, saliva, and urine of pets can cause allergic reactions and asthma symptoms. Reducing exposure to pets and maintaining a clean environment can help manage this trigger.

Choice D reason:

Emotional stress can also trigger asthma symptoms. Stress and strong emotions can lead to hyperventilation and changes in breathing patterns, which can exacerbate asthma. Stress management techniques and relaxation exercises can be beneficial in controlling asthma symptoms related to emotional stress.

Choice E reason:

Recent travel abroad is not typically considered a common trigger for asthma. While travel can expose individuals to different environmental factors and allergens, it is not a direct trigger like the other options listed. However, it is important for individuals with asthma to plan and prepare for travel to manage their condition effectively.

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The nurse has applied a client problem of ineffective gas exchange for a client diagnosed with chronic bronchitis. Which intervention would the nurse include in the plan of care?

Nursing Test Bank

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Explanation

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