A nurse is assessing a client who is experiencing hypovolemia. Which of the following manifestations should the nurse expect?

This is because a peak flow meter measures how fast you can push air out of your lungs when you blow out as hard and as fast as you can. This is called peak expiratory flow rate (PEFR) or peak expiratory flow (PEF). It shows how open the airways are in the lungs and can help detect early signs of worsening asthma.

Choice A is wrong because maintaining a semi-Fowler’s position during testing is not necessary. You can sit or stand up straight, but make sure you do it the same way each time.

Choice B is wrong because placing tongue on the mouthpiece of the meter can block the air flow and affect the accuracy of the measurement. You should close your lips tightly on the mouthpiece instead.

Choice D is wrong because recording the average of the readings is not recommended.

You should record the highest of the three readings on a sheet of paper, calendar or in your asthma diary. This is your daily peak flow.

Normal ranges for peak flow vary depending on age, height, gender and race. You can use a chart or calculator to find out your predicted normal peak flow based on these

factors. However, it is more important to find out your personal best peak flow by performing peak flow testing twice a day for two weeks when your asthma is under good control. Your personal best peak flow will be used to create your asthma action plan with your healthcare provider.

Partial separation of the upper part of the incisional line.

This is a sign of wound dehiscence, which is a serious complication that occurs when the edges of a surgical incision separate and the underlying tissues are exposed.

Wound dehiscence can lead to infection, bleeding, and evisceration (protrusion of internal organs through the incision). The nurse should report this finding to the provider immediately and cover the wound with a sterile dressing moistened with sterile saline solution.

Choice A is wrong because mild swelling under the sutures near the incisional line is a normal finding in the early stages of wound healing. It does not indicate infection or dehiscence unless accompanied by other signs such as redness, warmth, pain, or purulent drainage.

Choice B is wrong because crusting of exudate on the incisional line is also a normal finding that indicates the formation of a scab.

A scab protects the wound from infection and helps it heal faster. The nurse should not remove the scab unless instructed by the provider.

Choice D is wrong because pink-tinged coloration on the incisional line is another normal finding that shows healthy granulation tissue.

Granulation tissue is new tissue that fills in the wound and helps it close. It is usually pink or red and moist.

The nurse should follow these general tips for postoperative abdominal incision care:

• Always wash your hands before and after touching your incisions.
• Inspect your incisions and wounds every day for signs your healthcare provider has told you are red flags or concerning.
• Look for any bleeding.

If the incisions start to bleed, apply direct and constant pressure to the incisions.

• Avoid wearing tight clothing that might rub on your incisions.
• Try not to scratch any itchy wounds.
• You can shower starting 48 hours after your operation but no scrubbing or soaking of the abdominal wounds in a tub.
• After the initial dressing from the operating room is removed, you can leave the wound open to air unless there is drainage or you feel more comfortable with soft gauze covering the wound.
• Surgical glue (Indermil) will fall off over a period of up to 2-3 weeks. Do not put any topical ointments or lotions on the incisions.
• Do not rub over the incisions with a washcloth or towel.
• No tub baths, hot tubs, or swimming until evaluated at your clinic appointment.