A client with chronic obstructive pulmonary disease (COPD) has become extremely dyspneic. After determining that the client is in high- Fowler's position and is receiving oxygen via nasal cannula at 2 liters/minute, which immediate action should the nurse take?

Increase the client's oxygen to 6 liters/minute.

Obtain a stat arterial blood gas.

Lower the bed to a semi-Fowler's position.

Encourage the client to use pursed-lip breathing.

Answer and Explanation

The Correct Answer is B

A.   Increasing oxygen flow might seem like an immediate response, but it's crucial to be cautious with oxygen therapy in COPD patients. They often have a chronic CO2 retention issue, and excessive oxygen can sometimes reduce their drive to breathe, potentially worsening their condition. The increase in oxygen should be based on specific clinical guidelines and patient response, rather than an automatic increase.
B.   Obtaining a stat arterial blood gas (ABG) is an important diagnostic step to evaluate the client’s oxygenation, ventilation, and acid-base status. This can provide critical information on the severity of the dyspnea and guide further treatment. It’s an essential action, particularly in acute dyspnea, as it helps in understanding the underlying cause and tailoring appropriate interventions.
C.   The client is already in a high-Fowler’s position, which is optimal for improving lung expansion and easing dyspnea. Lowering the bed to a semi-Fowler’s position might not provide additional relief and could potentially worsen the client’s dyspnea. High-Fowler's position is generally preferred for severe dyspnea as it maximizes lung expansion and facilitates breathing.
D.   Pursed-lip breathing is a helpful technique for managing dyspnea in COPD patients. It helps to prolong exhalation, reduce airway collapse, and improve gas exchange. This technique can provide immediate relief by helping the client control their breathing and reduce feelings of breathlessness.

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Correct Answer is B

Explanation

A. While fatigue can contribute to decreased appetite, it is not as directly linked to the specific condition of trigeminal neuralgia.
B. Trigeminal neuralgia is characterized by severe, sharp facial pain, often triggered by chewing, talking, or even a gentle breeze. This pain would significantly deter a person from eating, leading to imbalanced nutrition.
C. Nausea is not a typical symptom of trigeminal neuralgia and would not be the primary cause of imbalanced nutrition in this case.
D. While altered taste can affect food enjoyment, it is less likely to completely deter someone from eating compared to the intense pain associated with trigeminal neuralgia.

A. "I will lift weights every other day." B. "I will be able to stand as long as my legs do not hurt." C. "I will avoid sitting and crossing my legs." D. "I will need to get someone to walk my dog."

Correct Answer is C

Explanation

A. Weight lifting can be beneficial for overall fitness, but for someone with chronic venous insufficiency, the focus should be on activities that improve venous return and avoid excessive strain on the legs. Heavy weight lifting might exacerbate symptoms or lead to further complications.
B. For individuals with chronic venous insufficiency, prolonged standing can worsen symptoms such as swelling and pain. It’s important to avoid standing for long periods and to use measures such as leg elevation and compression stockings to manage symptoms.
C. This statement reflects an understanding of good practices for managing chronic venous insufficiency. Sitting for prolonged periods and crossing the legs can impede venous return and worsen symptoms of CVI. It is advised to avoid these practices and instead frequently change positions, elevate the legs, and use compression stockings to improve circulation.
D. While getting help to walk a dog could be beneficial if the client is unable to walk or if walking exacerbates symptoms, this statement does not directly address key aspects of managing chronic venous insufficiency. Regular walking is generally recommended to enhance venous return and prevent complications, assuming it is done within the client’s tolerance and ability.

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A client with chronic obstructive pulmonary disease (COPD) has become extremely dyspneic. After determining that the client is in high- Fowler's position and is receiving oxygen via nasal cannula at 2 liters/minute, which immediate action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has determined that a client with trigeminal neuralgia has the nursing problem, "Imbalanced nutrition, less than body requirements." Which cause is most likely contributing to the problem?

Correct Answer is B

Explanation

A client with chronic venous insufficiency is being discharged from the hospital, and plans to return home. Which client statement indicates an understanding of home care instructions?

Correct Answer is C

Explanation

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