The nurse is caring for a client diagnosed with pneumonia. Which medication will the nurse administer for treatment of client's problem of ineffective airway clearance?

dextromethorphan 10 mg PO q 4 r

cromolyn MDI 2 puffs daily

guaifenesin 200 mg PO q 4 hr

methylprednisone 30 mg IV BID

Answer and Explanation

The Correct Answer is C

A. Dextromethorphan 10 mg PO q 4 hr: Dextromethorphan is a cough suppressant, and while it may be useful for controlling a dry, non-productive cough, it is not appropriate for ineffective airway clearance in pneumonia. In fact, suppressing the cough in pneumonia could prevent the patient from clearing mucus from the airways, exacerbating the problem. It is more appropriate for a client who has a dry cough without significant mucus production.

B. Cromolyn MDI 2 puffs daily: Cromolyn is a mast cell stabilizer used for the prevention of asthma and allergy symptoms, and it is not typically used for treating pneumonia or ineffective airway clearance. It works by preventing the release of inflammatory mediators in response to allergens, but it does not address the issue of clearing mucus in the airways during a bacterial infection like pneumonia.

C. Guaifenesin 200 mg PO q 4 hr: Guaifenesin is an expectorant that helps loosen and thin mucus in the airways, making it easier for the client to cough up and clear secretions. This is the most appropriate medication for addressing ineffective airway clearance in a client with pneumonia, as the goal is to facilitate the removal of mucus and improve respiratory function. Guaifenesin does not suppress the cough reflex but instead promotes productive coughing, which is essential for clearing the airways during a respiratory infection like pneumonia.

D. Methylprednisolone 30 mg IV BID: Methylprednisolone is a corticosteroid used to reduce inflammation and control severe allergic or inflammatory conditions. While corticosteroids may be used in certain cases of pneumonia (e.g., in cases of significant inflammation or an underlying condition like COPD), they are not the first-line treatment for ineffective airway clearance. The priority in this case is to promote mucus clearance, which is better addressed by guaifenesin.

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Correct Answer is C

Explanation

A) Assess for conjunctival bleeding
Conjunctival bleeding refers to blood in the white part of the eye (the conjunctiva), which is typically associated with trauma, infections, or certain blood disorders, but it is not a common cause of diplopia (double vision). Diplopia in multiple sclerosis (MS) is more often due to nerve damage affecting the eye muscles or the pathways controlling eye movement. Therefore, assessing for conjunctival bleeding is not a priority intervention for a client with diplopia related to MS.

B) Encourage the use of sunglasses when outside
While wearing sunglasses may help alleviate light sensitivity, which is a common symptom in individuals with MS, it is not the most appropriate intervention for treating diplopia itself. Diplopia is typically caused by issues with eye muscle control or coordination, often related to the central nervous system. Therefore, while sunglasses might provide comfort, they do not address the underlying cause of the double vision.

C) Alternate the use of an eye patch on each eye
Alternating the use of an eye patch on each eye is an effective intervention for managing diplopia, especially when the cause is related to misalignment or weakness of the eye muscles. The eye patch works by covering one eye at a time to prevent double vision. In MS, this technique can help reduce the visual disturbance and provide relief until further interventions (such as eye exercises or medications) can be considered. This approach is commonly used to manage diplopia caused by nerve involvement affecting ocular muscle function.

D) Apply cool compresses for pain relief
Cool compresses may provide relief for eye irritation or inflammation, but they are not typically used to treat diplopia. Diplopia in MS is more related to neuromuscular dysfunction or nerve damage, rather than acute inflammation or irritation of the eye. Therefore, while a cool compress may offer temporary relief for other symptoms, it is not a targeted solution for double vision in this context.

A. pH 7.32, Pa02 88 mmHg, PaCO2 50 mmHg, HCO3 29 mEq/L, 02 sat 94% B. pH 7.35, Pa02 98 mmHg, PaCO2 55 mmHg, HCO3 28 mEq/L, 02 sat 99% C. pH 7.64, PaO2 94 mmHg, PaCO2 23 mmHg, HCO3 14 mEq/L, 02 sat 88% D. PH 7.50, Pa02 91 mmHg, PaCO2 52 mmHg, HCO3 30 mEq/L, 02 sat 96%

Correct Answer is C

Explanation

A) pH 7.32, PaO2 88 mmHg, PaCO2 50 mmHg, HCO3 29 mEq/L, O2 sat 94%
This result suggests respiratory acidosis rather than respiratory alkalosis. In respiratory acidosis, the pH would be low (acidotic), PaCO2 would be elevated (since it reflects CO2 retention), and HCO3 would typically be elevated as a compensatory mechanism. This set of ABG values does not align with respiratory alkalosis, so it is not consistent with partially compensated respiratory alkalosis.

B) pH 7.35, PaO2 98 mmHg, PaCO2 55 mmHg, HCO3 28 mEq/L, O2 sat 99%
This set of values suggests respiratory acidosis, as indicated by a low pH (acidosis) and high PaCO2 (carbon dioxide retention). The HCO3 value is slightly elevated in compensation for respiratory acidosis, but this is not an example of partially compensated respiratory alkalosis, so it doesn't match the question's requirement.

C) pH 7.64, PaO2 94 mmHg, PaCO2 23 mmHg, HCO3 14 mEq/L, O2 sat 88%
This result is consistent with partially compensated respiratory alkalosis. In respiratory alkalosis, the pH would be elevated (alkalotic), PaCO2 would be low (indicating hyperventilation), and the kidneys would attempt to compensate by lowering bicarbonate (HCO3). In this case, the low PaCO2 (23 mmHg) and the low HCO3 (14 mEq/L) demonstrate partial compensation. The pH is also elevated at 7.64, which aligns with alkalosis. This is the correct answer for partially compensated respiratory alkalosis.

D) pH 7.50, PaO2 91 mmHg, PaCO2 52 mmHg, HCO3 30 mEq/L, O2 sat 96%
This result suggests respiratory acidosis with compensation. The elevated PaCO2 (52 mmHg) indicates CO2 retention, leading to acidosis, while the slightly elevated HCO3 (30 mEq/L) shows that the kidneys are compensating for the respiratory acidosis. The pH of 7.50 is slightly alkalotic, but it is more consistent with compensation for respiratory acidosis rather than respiratory alkalosis. Thus, this set of ABG values does not match the description of partially compensated respiratory alkalosis.

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The nurse is caring for a client diagnosed with pneumonia. Which medication will the nurse administer for treatment of client's problem of ineffective airway clearance?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client diagnosed with multiple sclerosis (MS) who is complaining of diplopia. Which intervention would be appropriate for the client with this problem?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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