A nurse is caring for a client who has emphysema. Which of the following findings should the nurse expect to assess in this client? (Select all that apply.)
Dyspnea
Barrel chest
Deep respirations
Clubbing of the fingers
Bradycardia
Correct Answer : A,B,D
These findings are expected to be assessed in a client who has emphysema, which is a type of chronic obstructive pulmonary disease (COPD) characterized by destruction and enlargement of alveoli, loss of elastic recoil, and air trapping. These changes impair gas exchange and oxygenation, leading to chronic hypoxia and hypercapnia.
a) Dyspnea, or difficulty breathing, is a common symptom of emphysema, as the client has reduced lung capacity and increased work of breathing. Dyspnea may be worse with exertion, stress, or infection, and may cause anxiety and fatigue. The nurse should monitor the client's respiratory rate, rhythm, depth, and effort, and provide oxygen therapy as prescribed.
b) Barrel chest, or increased anteroposterior diameter of the chest, is a physical sign of emphysema, as the client has chronic air trapping and hyperinflation of the lungs. Barrel chest may also cause kyphosis, or curvature of the spine, and reduced chest wall movement. The nurse should measure the client's chest circumference and observe for any deformities or asymmetry.
d) Clubbing of the fingers, or enlargement and rounding of the nail beds, is a late sign of emphysema, as the client has chronic hypoxia and tissue ischemia. Clubbing may also affect the toes and ears, and may indicate pulmonary or cardiac disease. The nurse should inspect the client's nails for shape, color, angle, and capillary refill.
c) Deep respirations are not expected to be assessed in a client who has emphysema, as the client has shallow and rapid breathing due to air trapping and reduced lung compliance. Deep respirations may indicate other conditions, such as metabolic acidosis or anxiety. The nurse should assess the client's arterial blood gas levels and provide reassurance and relaxation techniques as needed.
e) Bradycardia, or slow heart rate, is not expected to be assessed in a client who has emphysema, as the client has tachycardia or normal heart rate due to hypoxia and increased sympathetic stimulation. Bradycardia may indicate other conditions, such as medication side effects, vagal stimulation, or heart block. The nurse should monitor the client's pulse rate, rhythm, quality, and electrocardiogram as indicated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
2 capsules
To calculate the number of capsules, use the formula:
capsules = (desired dose in mg / available dose in mg) x 1 capsule
Plug in the given values:
capsules = (300 mg / 150 mg) x 1 capsule
Simplify and solve:
capsules = 2 x 1 capsule
capsules = 2 capsules
Round to the nearest whole number and add a leading zero if needed:
capsules = 2 capsules
Correct Answer is ["A","B","D"]
Explanation
Answer: A, B D
Rationale:
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Albuterol is a bronchodilator, and one of its key effects is to relax the muscles around the airways, which helps prevent wheezing. Wheezing is often caused by narrowed airways, and by opening them, albuterol helps to prevent this sound, which is associated with asthma or other respiratory conditions.
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B. The medication will decrease coughing episodes:
Albuterol can help decrease coughing in individuals with conditions like asthma or chronic obstructive pulmonary disease (COPD) by relaxing the muscles in the airways, which reduces airway constriction. Since coughing often occurs due to airway obstruction, albuterol’s bronchodilator effect can help alleviate this symptom. -
C. The medication will reduce inflammation: Albuterol does not have anti-inflammatory properties. Its primary mechanism is bronchodilation, and anti-inflammatory treatment generally requires corticosteroids, not beta-agonists like albuterol.
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D. The medication will open the airways:
This is correct. Albuterol works as a bronchodilator, meaning it opens up the airways by relaxing the smooth muscles surrounding them. This improves airflow and makes breathing easier, which is why it is often used in conditions like asthma or COPD. -
E. The medication will stimulate flow of mucus: Albuterol does not stimulate mucus production; it primarily works by relaxing the airways. However, by improving airflow, it can help clients more effectively expel mucus through coughing.
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