A nurse is caring for a child who is to receive percussion, vibration, and postural drainage. Which of the following actions should the nurse take first?

Instruct the client to cough

Perform vibration while the client exhales slowly through the nose.

Percuss the upper posterior chest.

Administer albuterol by nebulizer.

Answer and Explanation

The Correct Answer is D

A. Instruct the client to cough. Coughing is generally encouraged after chest physiotherapy to help expel loosened secretions, but it is not the first action. The bronchodilator should be administered first to maximize the effectiveness of the chest physiotherapy.

B. Perform vibration while the client exhales slowly through the nose. Vibration is a component of chest physiotherapy used to help loosen secretions during exhalation, but it is performed after the bronchodilator is administered and once the client is positioned properly.

C. Percuss the upper posterior chest. Percussion helps to mobilize secretions but is typically done after the bronchodilator has been administered to allow for more effective airway clearance.

D. Administer albuterol by nebulizer. Administering albuterol first dilates the airways, making it easier to mobilize and clear secretions during percussion, vibration, and postural drainage.

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Correct Answer is A

Explanation

A. Upright: This position allows for better expansion of the lungs and improved ventilation-perfusion matching, as gravity helps the diaphragm move downward and expand the lungs. It is often beneficial for patients with respiratory distress or failure.

B. Supine: While lying flat on the back (supine position) may be comfortable for some patients, it can restrict lung expansion, especially in individuals with compromised respiratory function. This position may not be ideal for maximal lung expansion in this scenario.

C. Prone: The prone position involves lying flat on the abdomen. In some cases, especially in adults with acute respiratory distress syndrome (ARDS), prone positioning has been shown to improve oxygenation by optimizing lung mechanics. However, it may not be practical or comfortable for all patients and is not typically used as a first-line intervention in school-age children with pneumonia.

D. Side-lying: While side-lying positions can sometimes improve lung expansion on the dependent side, it may not be as effective as the upright position in maximizing lung expansion, especially in cases of respiratory failure.

A. "I will restrict the amount of salt in my child's meals." B. "I will put my child in daycare to ensure that she socializes with other children." C. "I will make sure my child washes her hands before eating.” D. “I will provide low-fat meals for my child."

Correct Answer is C

Explanation

A. "I will restrict the amount of salt in my child's meals."

Restricting salt intake is not typically recommended for children with cystic fibrosis (CF). In fact, individuals with CF often have increased salt requirements due to excessive salt loss through sweat. Restricting salt intake could potentially lead to electrolyte imbalances. Therefore, this statement does not demonstrate an understanding of the dietary management necessary for CF.

B. "I will put my child in daycare to ensure that she socializes with other children."

While socialization is important for a child's development, placing a child with CF in daycare may increase their risk of exposure to respiratory infections, which can be particularly dangerous for individuals with CF due to their compromised respiratory function. Therefore, this statement does not demonstrate an understanding of the infection control measures necessary for managing CF.

C. "I will make sure my child washes her hands before eating.”

This statement demonstrates an understanding of infection control measures, which are crucial for individuals with CF to reduce the risk of respiratory infections. Washing hands before eating helps prevent the transmission of bacteria and viruses that can cause respiratory infections. Therefore, this statement indicates an understanding of an important aspect of managing CF.

D. “I will provide low-fat meals for my child."

Providing low-fat meals is not typically recommended for children with CF. CF often leads to malabsorption of fats, so a diet high in calories and fat is typically recommended to ensure adequate nutrition and weight gain. Therefore, this statement does not demonstrate an understanding of the dietary recommendations necessary for managing CF.

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A nurse is caring for a child who is to receive percussion, vibration, and postural drainage. Which of the following actions should the nurse take first?

Nursing Test Bank

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