A client with chronic obstructive pulmonary disease (COPD) is experiencing tachypnea and dyspnea. The nurse should plan to implement which of the following interventions to reduce bronchiolar collapse and air-trapping?
Instruct the client on pursed-lip breathing
Place the client in Trendelenburg position
Apply a high-frequency chest wall oscillation vest
Determine the client's FEV1/FVC ratio
The Correct Answer is A
A. Pursed-lip breathing is an effective technique for managing COPD symptoms, particularly tachypnea and dyspnea. It helps to keep the airways open by creating back pressure that prevents the collapse of bronchioles and reduces air-trapping. This technique improves ventilation and helps with the expiration of trapped air, making it a valuable intervention for COPD patients.
B. The Trendelenburg position involves lying flat on the back with the legs elevated higher than the head. This position is not suitable for managing COPD symptoms and can actually worsen breathing difficulties by increasing abdominal pressure on the diaphragm.
C. High-frequency chest wall oscillation (HFCWO) vests are used to help with airway clearance in conditions like cystic fibrosis or chronic bronchitis by loosening mucus. While beneficial for mucus management, they do not specifically address bronchiolar collapse or air-trapping associated with COPD.
D. Measuring the FEV1/FVC ratio is a diagnostic tool used to assess the severity of airflow obstruction in COPD. While this information is important for diagnosis and treatment planning, it is not an immediate intervention to manage symptoms such as tachypnea and dyspnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Peritonitis
Peritonitis is an infection of the peritoneum (the lining of the abdominal cavity), often related to peritoneal dialysis. It can present with abdominal pain, fever, rigidity, and rebound tenderness,
consistent with the client’s symptoms. Cloudy effluent is also a common sign of peritoneal dialysis- related peritonitis.
Peritoneal dialysis
Peritoneal dialysis is a type of dialysis that uses the peritoneum (abdominal lining) to filter blood. If there is an issue with the dialysis process, it could lead to complications such as peritonitis. This is consistent with the client's symptoms, such as abdominal pain, fever, nausea, vomiting, and cloudy effluent.
Correct Answer is D
Explanation
A. The ACTH stimulation test measures the adrenal glands' response to ACTH, not the kidneys.
B. In Addison’s disease, the adrenal glands are damaged and unable to produce sufficient cortisol even when stimulated by ACTH. Therefore, plasma cortisol levels will not rise significantly in response to
ACTH administration in individuals with Addison’s disease.
C. The ACTH stimulation test involves administering ACTH via injection, not orally.
D. ACTH (adrenocorticotropic hormone) is produced by the pituitary gland and stimulates the adrenal glands to produce cortisol. The ACTH stimulation test assesses how well the adrenal glands respond to ACTH, which is crucial for diagnosing conditions like Addison’s disease, where the adrenal glands do not respond appropriately.
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