A college health nurse interprets the peak expiratory flow rate for a student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should base her actions on which of the following information? (Select all that apply.)

The student needs to go to the hospital.

The nurse should obtain a second expiratory flow rate.

The student's peak flow is 50% to 80% of his best peak flow.

The student should use his quick-relief inhaler.

The student's asthma is not well controlled,

Answer and Explanation

Correct Answer : B,C,D,E

Asthma action plans often use a color-coded system to guide management based on peak expiratory flow rate (PEFR) measurements. The zones are typically green (80-100% of personal best), yellow (50-79% of personal best), and red (less than 50% of personal best).

A. The student needs to go to the hospital.

This is not necessarily required when the student is in the yellow zone. The yellow zone indicates caution and the need for intervention, but it does not immediately require hospitalization unless symptoms worsen or do not improve after using the quick-relief inhaler.

B. The nurse should obtain a second expiratory flow rate.

Confirming the peak flow measurement with a second reading ensures accuracy and helps to make informed decisions about the student's asthma management.

C. The student should use his quick-relief inhaler.

In the yellow zone, indicating moderate impairment, the use of a quick-relief (rescue) inhaler is often recommended to relieve symptoms and prevent progression to the red zone.

D. The student's peak flow is 50% to 80% of his best peak flow.

This is the correct range for the yellow zone, indicating moderate impairment. Action is needed to prevent worsening.

E. The student's asthma is not well controlled.

Being in the yellow zone indicates that the asthma is not well controlled and may require adjustments in the long-term management plan, including possible changes to daily controller medications.

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Correct Answer is C

Explanation

A. Flexing her ankles: Ankle flexion exercises and periodic ankle flexion are encouraged to promote blood circulation and prevent venous stasis, which can contribute to the development of venous thromboembolism (VTE).

B. Elevating her feet: Elevating the feet can also help prevent venous stasis and promote blood circulation. It is a recommended action to reduce the risk of VTE.

C. Massaging her legs: This is the correct answer. Massage of the legs, particularly deep tissue massage, can dislodge blood clots and increase the risk of embolization, including the risk of venous thromboembolism.

D. Ambulating soon after surgery: Early ambulation is an important preventive measure for VTE. It helps stimulate blood flow and prevents venous stasis. Encouraging the client to ambulate as soon as possible after surgery is a recommended practice.

A. Bumetanide 1 mg IV bolus every 12 hr B. Laboratory testing of serum potassium upon admission C. 0.9% normal saline IV at 50 mL/hr continuous D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain

Correct Answer is C

Explanation

Correct answer: C

A. Bumetanide 1 mg IV bolus every 12 hr is a loop diuretic used to help reduce fluid overload and manage heart failure symptoms. This medication helps remove excess fluid from the body and can be beneficial for a client with acute heart failure following an MI.

B. Laboratory testing of serum potassium upon admission: It is common to monitor serum potassium levels in patients receiving diuretics, especially loop diuretics, to prevent electrolyte imbalances.

C.Administering 0.9% normal saline IV at a continuous rate can potentially exacerbate heart failure by increasing fluid volume, leading to fluid overload and worsening symptoms. In acute heart failure, fluid management is critical, and fluids are typically restricted to prevent further strain on the heart.

D. Morphine sulfate 2 mg IV bolus every 2 hr PRN pain: Morphine sulfate is prescribed for pain management and is commonly used in acute heart failure situations to relieve anxiety and decrease preload on the heart. The dosing frequency is appropriate as "every 2 hr PRN" indicates it should be administered as needed for pain relief.

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A college health nurse interprets the peak expiratory flow rate for a student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should base her actions on which of the following information? (Select all that apply.)

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