The nurse is developing a plan of care for a client admitted with hypoxemia related to altered alveolar diffusion. When formulating a plan of care the nurse is aware which intervention must be included?

Providing pain management to adhere to coughing and deep breathing exercises

Teaching the client to use the tripod position

Adding humidity with supplemental oxygen to keep secretions thin

Supplying additional oxygen while the client is at rest

Answer and Explanation

The Correct Answer is C

A. Providing pain management to adhere to coughing and deep breathing exercises: While pain management is important for overall comfort and encouraging deep breathing and coughing, it is not the primary intervention for managing hypoxemia due to altered alveolar diffusion. The key intervention for hypoxemia from impaired alveolar diffusion focuses more on improving oxygenation and addressing the underlying cause.

B. Teaching the client to use the tripod position: The tripod position, which involves sitting upright and leaning forward with hands on knees, can help improve breathing for patients with certain respiratory conditions (e.g., COPD), but it is not directly related to the management of hypoxemia caused by altered alveolar diffusion.

C. Adding humidity with supplemental oxygen to keep secretions thin: Hypoxemia related to altered alveolar diffusion often results from difficulty in gas exchange due to thickened secretions or inflammation. Adding humidity to supplemental oxygen helps thin the secretions, making it easier to clear them, and can improve gas exchange in the lungs, which directly helps address the hypoxemia.

D. Supplying additional oxygen while the client is at rest: While providing supplemental oxygen to maintain adequate oxygen levels is important in managing hypoxemia, this option does not specifically address the issue of altered alveolar diffusion. Humidified oxygen can be more beneficial in improving secretion clearance and promoting better diffusion in such cases.

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Correct Answer is C

Explanation

A. Atorvastatin at bedtime to reduce my cholesterol levels.: is a statin used to lower cholesterol levels and reduce the risk of further cardiovascular events. It is commonly recommended to take statins in the evening because cholesterol synthesis occurs mostly at night. The client is following proper instructions here.

B. Metoprolol to decrease my heart's need for oxygen.: Metoprolol is a beta-blocker that reduces the heart's demand for oxygen by lowering the heart rate, blood pressure, and the force of contraction. This helps in reducing the risk of further complications after a myocardial infarction (MI).

C. Sublingual nitroglycerin each day to prevent chest pain.: This indicates the need for further education. Sublingual nitroglycerin is typically used as needed for acute chest pain or angina and should not be taken regularly each day for prevention. For long-term prevention, other medications like beta-blockers or calcium channel blockers are usually prescribed, not sublingual nitroglycerin. Taking nitroglycerin every day without chest pain could cause unnecessary side effects, such as hypotension or tolerance to the medication.

D. Clopidogrel to prevent clots from forming.: Clopidogrel is an antiplatelet medication that helps to prevent blood clots from forming by inhibiting platelet aggregation. It is often prescribed following a myocardial infarction to reduce the risk of further clot formation and to improve cardiovascular outcomes.

A. Heart failure. B. Ventricular dysrhythmias. C. Cor pulmonale, D. Increased bleeding

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

Explanation

A. Heart failure: An anterior wall myocardial infarction (MI) often affects the left ventricle, which is responsible for pumping oxygenated blood to the body. Damage to this area can impair the heart's ability to pump effectively, leading to heart failure. Left-sided heart failure is a common complication following an anterior wall MI.

B. Ventricular dysrhythmias: The anterior wall of the left ventricle is part of the area most vulnerable to ischemic damage during an MI. This damage can disrupt the electrical conduction system of the heart, leading to ventricular dysrhythmias, which are serious and life-threatening complications, particularly following an anterior wall MI.

C. Cor pulmonale: Cor pulmonale refers to right-sided heart failure caused by chronic lung disease, such as COPD or pulmonary hypertension. It is not typically a complication of an anterior wall MI. Anterior wall MIs primarily affect left-sided heart function.

D. Increased bleeding: Increased bleeding is not a typical complication of an anterior wall MI. While patients with MI may be treated with anticoagulants, bleeding is not directly related to the myocardial infarction itself. Instead, complications like heart failure, arrhythmias, or rupture of the ventricular wall are more commonly associated with an anterior wall MI.

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The nurse is developing a plan of care for a client admitted with hypoxemia related to altered alveolar diffusion. When formulating a plan of care the nurse is aware which intervention must be included?

Nursing Test Bank

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