When assessing a client with emphysema which finding would the nurse expect Quizlet
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Terms in this set (20)A nurse is teaching a client about chronic obstructive pulmonary disease (COPD). Which information should the nurse include? (Select all that apply.) COPD is a respiratory disorder that has components of chronic bronchitis and emphysema. COPD exacerbations cause shortness of breath and increased sputum production. Intermittent flare-ups of the symptoms are expected. Rationale: Chronic obstructive pulmonary disease (COPD) is an incurable disease. It is characterized by periods of exacerbation, or flare-ups. Lung tissue is permanently damaged with each exacerbation and does not return to normal. COPD does cause the symptoms of dyspnea and increased sputum production, and it is a disorder that includes both bronchitis and emphysema. The nurse is assessing a client who has chronic bronchitis. Which symptom should the nurse expect to find? (Select all that
apply.) Distended neck veins Cough with sputum production Wheezing Rationale: Clients with chronic bronchitis will exhibit distended neck veins, a cough with sputum production, and wheezing. The client with emphysema would present with diminished breath sounds and a barrel chest. The nurse is assessing a client diagnosed with emphysema. Which clinical manifestation should the nurse expect to find? (Select all that apply.) Barrel chest Diminished breath sounds Use of accessory muscles when breathing Rationale: Clinical findings that support the diagnosis of emphysema include a barrel chest, use of accessory muscles when breathing, and diminished breath sounds. A cough with copious amounts of sputum and hypercapnia are indicative of chronic bronchitis. The nurse is describing the effects of smoking. Which effect should be included? (Select all that apply.) Destruction of airways Inhibited function of alveolar macrophages Constriction of smooth muscle Rationale: Cigarette smoking has been known to cause inhibited function of alveolar macrophages, airway destruction, and constricted smooth muscle. Cigarette smoking causes impaired ciliary movement, not enhanced ciliary movement. Cigarette smoking causes mucus-secreting glands to hypertrophy, not atrophy. Which condition should the nurse understand occurs in the pathophysiology of emphysema? (Select all that apply.) Loss of elastic recoil of the lungs Enlargement of the alveoli Rationale: The pathophysiology of emphysema includes enlargement of the alveoli and loss of elastic recoil of the lungs. Decreased ciliary function, fluid buildup in the lungs, and excessive mucus production occur with chronic bronchitis, not emphysema. The nurse is teaching coughing techniques to a client with chronic obstructive pulmonary disease. Which technique should the
nurse include? Cough twice, the first time to loosen mucus and the second time to expel secretions. Rationale: Coughing twice is the correct method that should be included in the teaching. Prolonged coughing tends to be ineffective and increases fatigue. While oxygen therapy may be an important component of care, it is to prevent and treat hypoxemia. When inhaling before huff coughing, inhale or sniff though the nose to avoid pushing secretions back down into the lungs. Fluid intake should not be limited and is not part of coughing techniques that should be included in the teaching. The nurse is discussing dietary changes for a
client with chronic obstructive pulmonary disease. Which advice should the nurse include? Follow a low-salt diet. Rationale: A low-salt diet is recommended to prevent fluid retention, which can lead to dyspnea and edema. Fluids should not be restricted because they help liquefy secretions and prevent dehydration, and clients should be provided with careful recommendations for adequate fluid intake. High carbohydrates are not recommended, and dairy products should be avoided because they can thicken secretions. A 6-year-old child is diagnosed with chronic obstructive pulmonary disease (COPD). Which risk factor should the nurse expect to find in the child's history? Inherited genetic abnormality Rationale: Although secondhand cigarette smoke and exposure to air pollution is detrimental to children and can result in long-term lung effects, a deficiency of alpha-1 antitrypsin (AAt) is usually the cause of COPD in children in this age group and is an inherited genetic abnormality. Lung infections can lead to problems as the child ages. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has shortness of breath, a respiratory rate of 28 breaths/min, and an O2 saturation of 92%. Which intervention is contraindicated in this client? Putting the client in supine recumbent position Rationale: Individuals who experience COPD with chronic hypercarbia become dependent on low levels of oxygen in the blood as a stimulus for breathing. In keeping with this theory, the alleviation of hypoxia by way of supplemental oxygen administration may lead to respiratory depression or even respiratory failure. Percussion with vibration and postural draining, and administration of bronchodilators all may help reduce the symptoms. Putting the client in supine recumbent position would be contraindicated. The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about the benefits of an exercise regimen. Which information should the nurse include? (Select all that apply.) Dyspnea and fatigue may improve with exercise. Exercise can prevent the condition from worsening. Regular exercise improves exercise tolerance and muscle strength. An exercise regimen can improve the ability to perform activities of daily living (ADLs). Rationale: Exercise can enhance the client's ability to perform activities of daily living (ADLs) and may prevent deterioration of the physical condition. Regular exercise can improve exercise tolerance, muscle strength, and quality of life in clients with COPD and reduce dyspnea and fatigue. There are several techniques that the client should be taught to enhance breathing during exercise (such as pursed-lip and abdominal breathing). Rapid breathing will cause fatigue and changes in respiratory status. The nurse is discussing tests to evaluate the extent of chronic obstructive pulmonary disease (COPD). Which test should the nurse include? (Select all that apply.) Pulmonary function tests Ventilation-perfusion testing Arterial blood gas analysis Rationale: Diagnostic testing used for this client will include pulmonary function tests, ventilation-perfusion testing, and arterial blood gas analysis. Bronchoscopy and lung biopsy are not indicated for COPD diagnosis and are utilized to diagnose conditions that require direct visualization and testing of lung tissue (such as lung cancer). The nurse is planning a collaborative care conference for a client recently
diagnosed with chronic obstructive pulmonary disease. Which team member should the nurse invite? (Select all that apply.) Physical therapist Occupational therapist Respiratory therapist Nutritionist Rationale: When planning a care conference for a client with chronic obstructive pulmonary disease, a respiratory therapist, physical therapist, occupational therapist, and nutritionist should act as collaborative team members to plan this client's care. Billing specialists need not be involved in care conferences. The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) about the purpose of using a bronchodilator. Which explanation should the nurse include? Improves airflow and reduces air trapping Rationale: Bronchodilators improve airflow and reduce air trapping in clients with COPD, resulting in alleviating dyspnea and improving exercise tolerance. Most bronchodilators have short duration of effect, they do not have anti-inflammatory properties, and they act by relaxing bronchial smooth muscle, not strengthening contracting action. The nurse is leading a support group for clients and families with chronic obstructive pulmonary disease (COPD). Which item should be discussed as a method to prevent COPD exacerbations? (Select all that apply.) Yearly flu vaccine Restricting smoking in home environment Pneumococcal vaccine Use of cool mist humidifiers Rationale: Immunization against pneumococcal pneumonia and a yearly influenza vaccine are recommended to reduce the risk of respiratory infections. Cool mist humidifiers may help lubricate the airways and loosen mucus. Smoking is detrimental to the client, and the environment should remain smoke free. Cough suppressants have been shown to be ineffective for this condition. A client with end-stage chronic obstructive pulmonary disease (COPD) asks the nurse about lung surgery. Which is the best response by the nurse? "Lung reduction surgery is experimental but may be an option." Rationale: Lung transplants are done for adults with COPD, and the procedure has shown promising survival rates. Lung reduction surgery is an experimental option. The procedure reduces the overall volume of the lung, reshapes it, and improves elastic recoil. As a result, pulmonary function and exercise tolerance improve, and dyspnea is reduced. Oxygenation is closely monitored in a COPD client during surgery, but surgery is possible. The nurse is completing a health history of a client who has an exacerbation of chronic obstructive pulmonary disease. Which should the nurse obtain? Current medications Rationale: The nurse should inquire about the client's current medications during the health history. If the client is unable to provide the information, a family member can provide this to the nurse. Breath sounds, percussion tone, and peripheral pulses are physical assessment items that the nurse must obtain during the assessment, and they do not require a family member's involvement. The nurse is teaching a client with chronic obstructive pulmonary
disease (COPD) about types of irritants that should be avoided. Which irritant should the nurse include? (Select all that apply.) Dust Air pollution Smoke Pets Rationale: The nurse should teach a client with COPD to avoid indoor pollutants, smoke, dust, and air pollution. The client should also avoid very cold, dry air, not warm, humid air. Allergies to pets can cause respiratory distress as well. The nurse reviews the arterial blood gas (ABG) results of a client with end-stage chronic obstructive pulmonary disease (COPD). Which finding should the nurse expect? Hypercapnia with hypoxia Rationale:
Hypercapnia, or elevated The nurse gave discharge instructions to a client who has chronic obstructive pulmonary disease (COPD). Which action by the client indicates that the teaching was effective? Wears an identification band and carries a list of medications Rationale: Wearing an identification band and carrying a current list of medications is very important in case of emergency. The client with COPD should eat small, frequent meals, because the effort of eating can lead to fatigue. Oxygen saturation in a COPD client should be around 90%. Higher saturations can affect the drive to breathe. Adequate fluid intake is important, but it should be between 0.5 to 2.5 quarts per day. The client with chronic obstructive pulmonary disease has severe hypercapnia, hypoxemia, lethargy, and cyanotic nail beds. Which treatment should the nurse expect to be ordered? Endotracheal intubation Rationale: This client is in respiratory failure and is decompensating. Intubation will aid in increasing oxygenation (which will treat the lethargy and cyanosis) and decrease the Students also viewedCOPD NCLEX REVIEW PEARSON20 terms wambo1 COPD NCLEX Questions20 terms Sking0919 Chapter 31 - COPD (Questions)17 terms ChloeKyloe NCLEX Question- COPD20 terms mary_g_mcdaniel Sets found in the same folderNCLEX Questions- Asthma20 terms mary_g_mcdaniel Chapter 26: Upper Respiratory Problems Lewis: Medi…25 terms bel9520 Chapter 28: Care of Patients Requiring Oxygen Ther…27 terms Catalina78222 Lewis Chapter 28: Obstructive Pulmonary Diseases43 terms morgan_marie775 Other sets by this creatorpolicy20 terms trdwyer SPI20 terms trdwyer tbi20 terms trdwyer ICP20 terms trdwyer Recommended textbook solutionsClinical Reasoning Cases in Nursing7th EditionJulie S Snyder, Mariann M Harding 2,512 solutions
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Which of the following clinical findings is common with emphysema?Symptoms of emphysema may include coughing, wheezing, shortness of breath, chest tightness, and an increased production of mucus. Often times, symptoms may not be noticed until 50 percent or more of the lung tissue has been destroyed.
Which of the following occurs with emphysema quizlet?Which of the following occur with emphysema? The walls of the alveoli degenerate, decreasing the surface area for gas exchange.
What are the two clinical manifestations of emphysema?Early symptoms of pulmonary emphysema may include: Cough. Rapid breathing. Shortness of breath, which gets worse with activity.
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