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A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?

Hgb 20 g/dL

Oxygen saturation 92%

Productive cough with green sputum

Chest x-ray shows hyperinﬂation of lungs

Answer and Explanation

The Correct Answer is A

Answer: A

Rationale:

A) Hgb 20 g/dL:

A hemoglobin level of 20 g/dL is elevated and suggests polycythemia, which can occur in chronic respiratory conditions like COPD due to chronic hypoxia. Elevated hemoglobin levels can increase blood viscosity, leading to complications such as increased risk of thrombosis and cardiovascular stress. This finding indicates a potentially serious issue and should be reported to the healthcare provider immediately to address any underlying causes and manage the client's condition effectively.

B) Oxygen saturation 92%:

An oxygen saturation of 92% is slightly below the typical normal range (95-100%) but is not immediately life-threatening. While it indicates mild hypoxemia, it is a common finding in COPD patients, and the management would typically involve supplemental oxygen or adjustment of therapy. This finding should be monitored but is not the most critical issue to report immediately.

C) Productive cough with green sputum:

A productive cough with green sputum suggests a possible infection or exacerbation of COPD. Although this is an important finding that requires evaluation and possible treatment, it is less critical than an elevated hemoglobin level, which indicates a more acute systemic issue. The green sputum should be reported and managed, but it is not the priority compared to the elevated hemoglobin.

D) Chest x-ray shows hyperinflation of lungs:

Hyperinflation of the lungs is a common radiological finding in COPD due to air trapping. While it is a significant finding, it is generally consistent with the disease's progression and does not indicate an acute problem requiring immediate intervention. Monitoring and managing the underlying COPD are necessary, but this finding is less urgent than the elevated hemoglobin.

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Correct Answer is D

Explanation

Answer: D

Rationale:

A) "Wash your newborn's head under a stream of running water": Washing the newborn's head under a stream of running water is not safe due to the risk of startling the baby or causing discomfort. Instead, the head should be gently washed using a damp cloth or sponge.

B) "Bathe your newborn within 30 minutes after a feeding": Bathing a newborn within 30 minutes after feeding is not advisable as it may cause discomfort or spitting up due to the baby's full stomach. It is better to wait for some time after feeding before bathing the baby.

C) "Start the bath by washing the newborn's diaper area first": Starting the bath by washing the newborn's diaper area first is not recommended. The face and head should be washed first to avoid spreading bacteria from the diaper area to other parts of the body.

D) "The bath water should be 100 to 103 degrees Fahrenheit": This is the correct temperature range for a newborn's bath water. It is essential to ensure that the water is warm enough to be comfortable but not too hot, to avoid burns or discomfort. The temperature should be checked with a thermometer or the elbow to ensure it is safe for the baby.

A. A client who had surgery for cataract removal and lives in a rural location. B. A client who has hemiparesis and lives alone C. A client who requires assistance to pay for dressing supplies D. A client who requires instruction regarding medication administration

Correct Answer is B

Explanation

b. A client who has hemiparesis and lives alone.

Explanation:

The correct answer is b. A client who has hemiparesis and lives alone.

An interdisciplinary care conference involves the collaboration of multiple healthcare professionals from diﬀerent disciplines to develop a comprehensive care plan for a client. In this scenario, the client with hemiparesis who lives alone requires an interdisciplinary care conference because their condition and living situation present complex challenges.

Clients who had surgery for cataract removal and live in a rural location (option a) may require support with transportation and follow-up appointments, but it does not necessarily warrant an interdisciplinary care conference.

A client who requires assistance to pay for dressing supplies (option c) may benefit from financial counseling or resources, but it does not typically require the involvement of multiple healthcare professionals in a care conference.

A client who requires instruction regarding medication administration (option d) can typically receive education from a nurse or pharmacist without the need for an interdisciplinary care conference.

In contrast, the client with hemiparesis who lives alone may require input from various professionals such as physical therapists, occupational therapists, social workers, and home healthcare providers to address their physical limitations, safety concerns, and support needs. Therefore, an interdisciplinary care conference is necessary to develop a comprehensive discharge plan that addresses all aspects of their care and promotes their well-being in the community.

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A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?

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