A client with pulmonary embolism is experiencing severe shortness of breath. Which nursing intervention takes priority in this situation?
Administering pain medication
Initiating anticoagulant therapy
Providing supplemental oxygen
Encouraging ambulation
The Correct Answer is C
A) Incorrect. While pain management is important, providing supplemental oxygen to address severe shortness of breath takes priority.
B) Incorrect. Initiating anticoagulant therapy is essential but may take some time to have an effect. Oxygen therapy should be provided immediately to address the client's oxygenation.
C) Correct. Providing supplemental oxygen is the priority intervention for a client with severe
shortness of breath to ensure adequate oxygenation.
D) Incorrect. Encouraging ambulation is not appropriate in a client with severe shortness of breath. Stabilizing the client's oxygenation and condition is the immediate concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Incorrect. An IVC filter is not used to administer anticoagulant medications but rather to prevent blood clots from reaching the pulmonary circulation.
B) Incorrect. IVC filters are not used to prevent airway obstruction.
C) Correct. The primary purpose of an IVC filter is to capture and prevent blood clots from reaching the pulmonary circulation, reducing the risk of pulmonary embolism.
D) Incorrect. IVC filters are not used to deliver oxygen directly to the lungs but rather to prevent emboli from reaching the lungs.
Correct Answer is D
Explanation
A) Incorrect. Jaundice is a yellowing of the skin and sclera due to elevated bilirubin levels, which is not described in the client's symptoms.
B) Incorrect. Pallor refers to paleness of the skin, which is not consistent with the client's cyanosis.
C) Incorrect. Erythema refers to redness of the skin due to increased blood flow, which is not the best description of the client's symptoms.
D) Correct. Cyanosis is the bluish discoloration of the skin, lips, and nail beds due to decreased oxygen saturation in the blood, which is indicative of a severe oxygen deficit often seen in pulmonary embolism.
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