The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who is reporting dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What does this finding indicate to the nurse about this patient?

Bronchoconstriction

Pulmonary edema

Hemoptysis

Pneumothorax

Answer and Explanation

The Correct Answer is A

Choice A reason: Wheezing is a typical sound heard during bronchoconstriction, which occurs in conditions like asthma and COPD. It indicates that the airways are narrowed, causing the characteristic sound.

Choice B reason: Pulmonary edema typically presents with crackles or rales rather than wheezing. Wheezing would not be the primary indication of this condition.

Choice C reason: Hemoptysis refers to coughing up blood and does not typically present with wheezing. It might present with other sounds if there is an underlying lung issue, but wheezing is not specific to it.

Choice D reason: Pneumothorax generally presents with decreased or absent breath sounds on one side, not wheezing. It occurs when air enters the pleural space, causing lung collapse.

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

Explanation

Choice A reason: A pH less than 7.35 indicates an acidic state, which is consistent with metabolic acidosis. The normal pH range is 7.35 to 7.45.

Choice B reason: HCO3 (bicarbonate) less than 22 mEq/L indicates a low level of bicarbonate, which is consistent with metabolic acidosis. Bicarbonate is a base, and lower levels indicate a loss of buffering capacity.

Choice C reason: PaCO2 greater than 45 mmHg is not a primary indicator of metabolic acidosis but can occur as a compensatory mechanism in response to respiratory acidosis. The primary indicators of metabolic acidosis are low pH and low bicarbonate.

Choice D reason: PaO2 less than 80 mmHg indicates hypoxemia but is not directly related to the diagnosis of metabolic acidosis. Hypoxemia can occur with various conditions, and while it may be present, it is not a defining characteristic of metabolic acidosis.

Choice E reason: SpO2 greater than 95% indicates normal oxygen saturation and is not relevant to the diagnosis of metabolic acidosis. Oxygen saturation primarily reflects respiratory function rather than acid-base balance.

A. Perform weekly occult blood testing with gastric analysis test. B. Discuss nutritional management with inclusion of high-protein, high-vitamin diet. C. Leave ostomy site open to air for an hour each day when changing the appliance. D. Instruct the patient and family how to give medications through their G-tube.

Correct Answer is B

Explanation

Choice A reason: Performing weekly occult blood testing with gastric analysis is not typically required for managing IBD at home. This intervention is more invasive and usually performed under specific medical instructions rather than as a routine home care intervention.

Choice B reason: Discussing nutritional management with the inclusion of a high-protein, high-vitamin diet is crucial for patients with IBD. These patients often experience malnutrition due to poor absorption and increased nutritional needs during flare-ups. A high-protein, high-vitamin diet can help promote healing, maintain muscle mass, and prevent deficiencies.

Choice C reason: Leaving the ostomy site open to air for an hour each day when changing the appliance is not recommended. Ostomy sites need to be kept clean and protected to prevent infection and skin irritation.

Choice D reason: Instructing the patient and family on how to give medications through their G-tube is not relevant if the patient has an ileostomy. The focus should be on ostomy care and management

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The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who is reporting dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What does this finding indicate to the nurse about this patient?

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The nurse is caring for a patient with metabolic acidosis. Which laboratory findings will the nurse expect to support this diagnosis? (Select All That Apply)

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

Explanation

The nurse is creating a home care checklist for a patient diagnosed with inflammatory bowel disease (IBD) who is being discharged. The patient has an ileostomy from a previous surgery. What intervention will the nurse include in this plan?

Correct Answer is B

Explanation

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The nurse is assessing a patient with chronic obstructive pulmonary disease (COPD) who is reporting dyspnea. The nurse auscultates the patient's chest and hears wheezing throughout the lung fields. What does this finding indicate to the nurse about this patient?

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