A client with chronic obstructive pulmonary disease (COPD) smokes two packs of cigarettes per day and is admitted to the hospital for a respiratory infection. The client reports difficulty controlling respiratory distress at home when using the rescue inhaler. Which comment from the client indicates to the nurse that the client is not using the inhaler properly?
"I have a hard time inhaling and holding my breath after I squeeze the inhaler, but I do my best."
"I never use the inhaler unless I am feeling really short of breath."
"After I squeeze the inhaler and swallow, I always feel a slight wave of nausea, but it goes away."
"I always shake the inhaler several times before I start."
The Correct Answer is C
Rationale
A. This comment suggests that the client is aware of the correct technique (inhaling and holding breath) but finds it difficult to execute properly. It indicates a partial understanding of the inhaler technique but potential difficulty in coordination.
B. This comment indicates a misunderstanding of the purpose of a rescue inhaler. Rescue inhalers are intended to be used promptly at the onset of symptoms to relieve acute shortness of breath. Delaying use until symptoms are severe may result in inadequate relief and worsening of respiratory distress.
C. This comment suggests that the client may be swallowing the medication instead of inhaling it into the lungs. Inhalers are meant to deliver medication directly into the lungs through inhalation, not swallowing. Swallowing the medication can lead to gastrointestinal side effects like nausea.
D. Shaking the inhaler before use is a correct step to ensure proper dispersion of the medication. This comment indicates the client understands and follows this part of the inhaler technique correctly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["18"]
Explanation
(Desired Dose * Volume of IV Bag) / (Concentration of Drug in IV Bag * Time) = Infusion Rate.
For the given prescription, the calculation would be: (900 units/hr * 500 mL) / (25,000 units) = 18 mL/hr.
Therefore, the nurse should program the infusion pump to deliver 18 mL/hr.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
The nurse recognizes that this client is Hemorrhaging due to uterine atony.
Rationale
This client is likely experiencing hemorrhaging, as indicated by the boggy fundus (uterine atony), saturated pad and sheets with blood, and the significant estimated blood loss of 600 mL after delivery. Hemorrhaging refers to excessive bleeding, which can occur due to various reasons in the postpartum period, including uterine atony.
The boggy fundus (uterus) at 1 cm above the umbilicus suggests poor uterine tone, which is indicative of uterine atony. Uterine atony is a common cause of postpartum hemorrhage and occurs when the uterus fails to contract adequately after delivery, leading to excessive bleeding.
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