A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take?

Determine the cause of the acute exacerbation.

Obtain a peak ﬂow reading.

Administer an inhaled glucocorticoid.

Administer a short-acting beta2-agonist (SABA).

Answer and Explanation

The Correct Answer is D

Administering a short-acting beta2-agonist (SABA), such as albuterol, is the priority intervention for the nurse to take, as it provides rapid bronchodilation and relieves bronchospasm, which are the main features of status asthmaticus. Status asthmaticus is a severe and life-threatening asthma attack that does not respond to usual treatment and requires immediate medical attention.

a)   Determining the cause of the acute exacerbation is important, but not the priority intervention for the nurse to take. The cause may be an allergen, infection, stress, or exercise, but it does not aﬀect the immediate management of status asthmaticus. The nurse should focus on restoring airway patency and oxygenation first, and then identify and avoid triggers later.
b)   Obtaining a peak ﬂow reading is important, but not the priority intervention for the nurse to take. The peak ﬂow reading measures the maximum expiratory ﬂow rate and indicates the degree of airway obstruction. However, it may not be feasible or accurate in a child who is experiencing status asthmaticus, as they may be too dyspneic or agitated to perform the test. The nurse should rely on other signs of respiratory distress, such as wheezes, retractions, cyanosis, or pulse oximetry.
c)   Administering an inhaled glucocorticoid is important, but not the priority intervention for the nurse to take. Glucocorticoids, such as ﬂuticasone or budesonide, reduce inﬂammation and mucus production in the airways, but they have a delayed onset of action and are not eﬀective for acute asthma attacks. They are used for long-term control and prevention of asthma symptoms.

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Correct Answer is ["A","D"]

Explanation

These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.

b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on coughing, which is a reﬂex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inﬂammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking ﬂuids, using a humidifier, or taking an expectorant.
c) The medication will reduce inﬂammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inﬂammatory eﬀect on the airways, which are often inﬂamed and swollen in clients who have asthma or COPD. Inﬂammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inﬂammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inﬂammation.
e) The medication will stimulate ﬂow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct eﬀect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate ﬂow of mucus, such as drinking ﬂuids, using a humidifier, or taking an expectorant.

A. Disconnect the chest tube from the drainage system during transport. B. Empty the collection chamber prior to transport. C. Clamp the chest tube prior to transferring the client to a wheelchair. D. Keep the drainage system below the level of the client's chest at all times.

Correct Answer is D

Explanation

Keeping the drainage system below the level of the client's chest prevents backﬂow of ﬂuid or air into the
pleural space and maintains negative pressure in the system.

a) Disconnecting the chest tube from the drainage system during transport is dangerous and can cause pneumothorax, infection, or bleeding. The chest tube should remain connected to the drainage system at all times unless ordered by the provider.
b) Emptying the collection chamber prior to transport is unnecessary and can interfere with accurate measurement of drainage. The collection chamber should be emptied only when it is full or at the end of each shift.
c) Clamping the chest tube prior to transferring the client to a wheelchair is contraindicated and can cause tension pneumothorax, as it prevents air from escaping the pleural space. The chest tube should only be clamped for a brief period when changing the drainage system or checking for air leaks, and only with a provider's order.

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A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

Correct Answer is ["A","D"]

Explanation

A nurse is caring for a client who has a chest tube connected to a closed drainage system and needs to be transported to the x-ray department. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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