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 C

Explanation

A. While excessive consumption of certain beverages can potentially affect urinary health, diet drinks are generally not a primary risk factor for UTIs. The key risk factors for UTIs typically involve issues related to urinary retention, hygiene, and anatomical predispositions rather than beverage consumption alone.
B. Not voiding when the urge occurs, also known as urinary retention, can increase the risk of UTIs. When urine is retained in the bladder for extended periods, it can provide an environment where bacteria can proliferate, leading to infections. This behavior is a significant risk factor for developing UTIs, as it contributes to urinary stasis.
C. A multipara with a history of pyelonephritis is at increased risk for future UTIs. A history of pyelonephritis indicates that the client has experienced a serious urinary infection in the past, which could make her more susceptible to recurrent infections. This is a significant risk factor for developing UTIs again.
D. Urinary incontinence, especially in older adults, can be associated with increased risk for UTIs due to factors like poor hygiene, the presence of residual urine, and possible skin breakdown. While incontinence is a risk factor, it is often considered less directly related to recurrent UTIs compared to issues like urinary retention or a history of severe infections.

A. An increase in the hematocrit (HCT) from 42% (0.42 volume fraction) to 52% (0.52 volume fraction). B. An increase in the blood glucose level from 130 mg/dl. (7.22 mmol/L). C. A decrease in blood urea nitrogen (BUN) from 36 mg/dL (12.9 mmol/L) to 23 mg/dL (8.21 mmol/L). D. A decrease in serum amylase from 24 units/dl (240 units) to 12 units/dl. (120 units/L);

Correct Answer is C

Explanation

A. This would indicate fluid volume deficit, not improvement. Increasing IV fluids should lead to a decrease in hematocrit, not an increase.
B. This is not a desired outcome for a patient with pancreatitis, as hyperglycemia is a common complication. The focus should be on maintaining stable blood glucose levels.
C. BUN is a marker of kidney function and hydration status. A decrease in BUN indicates improved renal perfusion, which is a therapeutic outcome of increasing IV fluids.
D. While a decrease in amylase is generally a good sign for pancreatitis, it is not a direct result of increasing IV fluids. Amylase levels decrease as the pancreatitis improves.

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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?

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Naxlex Comprehensive Predictor Exams

The nurse is developing a teaching handout for female clients who return to the clinic for recurring urinary tract infections (UTI). Which client has the greatest risk for developing a UTI?

Correct Answer is C

Explanation

Correct Answer is C

Explanation

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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?

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