A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

Asking the provider to repeat another radiograph of the chest

Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client

Requesting the pharmacy to dispense 10 mL of dextromethorphan PO

Instructing respiratory therapy to administer a PRN albuterol aerosol

Answer and Explanation

The Correct Answer is D

A. Asking the provider to repeat another radiograph of the chest.

This option is not the most appropriate action in this scenario. While a chest radiograph may be useful in certain situations to assess for complications such as pneumothorax or pneumonia, it is not typically the first intervention for an asthma exacerbation with increased wheezing and decreased oxygen saturation. In this acute situation, the priority is to provide immediate treatment to alleviate the client's symptoms and improve oxygenation.

B. Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client.

While maintaining adequate oxygenation is important, especially in a client with asthma exacerbation, it is not the first-line intervention in this scenario. Oxygen supplementation may be necessary, but the priority is to address the underlying bronchospasm causing the decreased oxygen saturation. Therefore, this option may be considered after initiating appropriate bronchodilator therapy.

C. Requesting the pharmacy to dispense 10 mL of dextromethorphan PO.

This option is not appropriate for managing an asthma exacerbation. Dextromethorphan is a cough suppressant and does not address the underlying bronchospasm characteristic of asthma exacerbations. In fact, suppressing cough may hinder the clearance of mucus and exacerbate respiratory distress. Therefore, this intervention is not indicated and may delay appropriate treatment.

D. Instructing respiratory therapy to administer a PRN albuterol aerosol.

This is the correct action in this scenario. Albuterol is a short-acting bronchodilator commonly used to relieve bronchospasm and improve airflow in clients experiencing asthma exacerbations. Administering albuterol via aerosolized inhalation helps to quickly deliver the medication directly to the airways, providing rapid relief of symptoms such as wheezing and improving oxygenation. Therefore, instructing respiratory therapy to administer a PRN albuterol aerosol is the most appropriate intervention to address the client's acute symptoms.

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Correct Answer is D

Explanation

A. Pigeon

A pigeon chest, also known as pectus carinatum, is a deformity of the chest characterized by a protrusion of the sternum and ribs, resulting in a pigeon-like appearance of the chest. This deformity is not typically associated with COPD.

B. Funnel

A funnel chest, also known as pectus excavatum, is a deformity of the chest characterized by a depression or concavity in the sternum, resulting in a funnel-like appearance of the chest. This deformity is not typically associated with COPD.

C. Kyphotic

Kyphosis refers to an exaggerated forward curvature of the thoracic spine, leading to a hunched or rounded upper back. While individuals with severe COPD may develop kyphosis due to chronic respiratory muscle fatigue and increased work of breathing, kyphotic curvature is not specific to COPD and can occur in other conditions as well.

D. Barrel

In COPD (Chronic Obstructive Pulmonary Disease), the client's chest may take on a barrel shape. This is characterized by an increase in the anterior-posterior diameter of the chest, resulting in a more rounded appearance similar to that of a barrel. This change in chest shape is due to hyperinflation of the lungs, which occurs as a result of air trapping and increased residual volume in the lungs, common in COPD.

A. 2 mL B. 10 mL C. 25mL D. 12.5 mL

Correct Answer is B

Explanation

First, we need to find out how many milligrams (mg) are in 1 milliliter (mL) of the available diphenhydramine solution:

12.5 mg/5 mL

To find out how many milligrams are in 1 mL, we divide the total milligrams by the total milliliters:

12.5 mg ÷ 5 mL = 2.5 mg/mL

Now that we know the concentration of diphenhydramine is 2.5 mg/mL, we can calculate the dose needed for the order of 25 mg:

25 mg ÷ 2.5 mg/mL = 10 mL

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A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

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Order: Diphenhydramine 25mg Q4H Available: Diphenhydramine 12.5mg/5mL How much will you administer?

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