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 B
Explanation
A. Parkinson's disease is not generally considered to be caused by an autoimmune reaction or a recent infection. Autoimmune reactions leading to neurodegeneration are more commonly associated with other conditions such as multiple sclerosis, not Parkinson's disease.
B. The exact cause of Parkinson's disease is indeed unknown, but research suggests that it results from a combination of genetic predispositions and environmental factors. Genetic mutations may contribute to the development of Parkinson's disease in some individuals, while environmental factors such as exposure to certain toxins or other external influences might also play a role. The interplay between these factors is still being studied.
C. There is no evidence to support the idea that Parkinson's disease is caused by the reactivation of a virus affecting cranial nerve VII (the facial nerve). Parkinson's disease involves the degeneration of dopamine-producing neurons in the brain, not specifically related to viral reactivation or isolated to cranial nerve VII.
D. Demyelination of nerves is characteristic of multiple sclerosis, not Parkinson's disease. In Parkinson's disease, the primary issue is the loss of dopamine-producing neurons in the substantia nigra of the brain, not demyelination. This option describes a different pathological process unrelated to Parkinson's disease.
Correct Answer is C
Explanation
A. Elevated potassium levels (hyperkalemia) can occur in chronic kidney disease, as the kidneys struggle to excrete potassium. However, hyperkalemia does not typically cause visible crystals on the skin. It is more associated with cardiac arrhythmias and muscle weakness rather than skin manifestations.
B. Sodium imbalance is common in chronic kidney disease, often leading to fluid retention and hypertension. However, excess sodium does not result in crystal formation on the skin. Sodium issues are more related to fluid balance and blood pressure, not external crystalline deposits.
C. Urea is a waste product formed from the breakdown of proteins and is normally excreted by the kidneys. In chronic kidney disease, urea accumulates in the blood (uremia) because the kidneys cannot effectively filter it out. Urea can be deposited on the skin and form crystals, leading to a condition known as "uremic frost." This is often observed on the forehead or other areas of the skin and is a direct result of excess urea in the body.
D. Creatinine is another waste product filtered by the kidneys. Elevated levels indicate impaired kidney function, but creatinine itself does not form visible crystals on the skin. Elevated creatinine levels are primarily used as an indicator of kidney function rather than a cause of external skin manifestations.
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