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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Answer: B. Elevated skin patches
Rationale:
A. Constipation:
Constipation is not a typical adverse effect of cefazolin. Antibiotics generally cause gastrointestinal symptoms like diarrhea rather than constipation, so this is not a primary concern with cefazolin therapy.
B. Elevated skin patches:
Elevated skin patches may indicate an allergic reaction, such as hives or a rash, which can be a serious side effect of cefazolin. Allergic reactions to antibiotics can escalate quickly and may require immediate medical attention. Monitoring for and reporting any skin changes is important to prevent potential complications.
C. Ringing in the ears:
Tinnitus (ringing in the ears) is not commonly associated with cefazolin. This symptom is more frequently associated with certain other antibiotics, such as aminoglycosides, but is not a primary concern with cefazolin use.
D. Depression:
Depression is not a known side effect of cefazolin. While mood changes may be seen with some medications, cefazolin’s primary side effects are related to hypersensitivity reactions and gastrointestinal symptoms.
Correct Answer is C
Explanation
Ciprofloxacin is an antibiotic commonly prescribed for the treatment of various bacterial infections. It belongs to a class of medications known as fluoroquinolones. One potential side effect of ciprofloxacin is increased sensitivity to sunlight, which can lead to a higher risk of sunburn. Therefore, it is important for the client to take precautions, such as using sunscreen, wearing protective clothing, and avoiding excessive sun exposure while taking this medication.
"Take an antacid if the medication causes gastrointestinal upset": Ciprofloxacin can be taken with or without food, but it should not be taken with antacids, calcium supplements, or other products containing aluminum, magnesium, or calcium, as they can interfere with the absorption of the medication. If gastrointestinal upset occurs, it is generally recommended to take the medication with food to minimize this side effect.
"Restrict your daily fluid intake while taking this medication": There is no need to restrict fluid intake while taking ciprofloxacin unless specifically instructed by the healthcare provider.
Adequate hydration is important to maintain overall health and prevent potential complications.
"Expect to experience diarrhea while taking this medication": Diarrhea can be a potential side effect of ciprofloxacin, but it is not a universal experience for all individuals taking the medication. It is more appropriate to inform the client about the potential side effects of ciprofloxacin, including gastrointestinal upset, and to encourage them to report any significant or persistent symptoms to their healthcare provider
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