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 B
Explanation
White coating in the mouth, also known as oral candidiasis or thrush, is a serious adverse effect of fluticasone/salmeterol, which is a combination of an inhaled corticosteroid and a long-acting beta2 agonist. It is caused by fungal infection of the oral cavity due to suppression of the normal flora by the corticosteroid component. The client should report this symptom to the provider, as it may require antifungal treatment and discontinuation of the medication.
a) Dry oral mucous membranes is a common and mild adverse effect of fluticasone/salmeterol, which can be relieved by drinking water, chewing sugarless gum, or using artificial saliva. It does not require reporting to the provider or stopping the medication.
c) Sedation is not an adverse effect of fluticasone/salmeterol, but it may be caused by other medications, such as antihistamines, opioids, or benzodiazepines. The client should avoid driving or operating machinery if sedated and consult with the provider about possible drug interactions.
d) Increased appetite is not an adverse effect of fluticasone/salmeterol, but it may be caused by other factors, such as stress, boredom, or hormonal changes. The client should maintain a balanced diet and exercise regularly to prevent weight gain and promote health.
Correct Answer is C
Explanation
Heparin is an anticoagulant that prevents the formation of new clots and the extension of existing clots. It is the drug of choice for treating acute pulmonary embolism, which is a life-threatening condition caused by a blood clot that travels to the lungs and blocks a pulmonary artery.
a) Dexamethasone is a corticosteroid that reduces inflammation and suppresses immune response. It is not indicated for treating pulmonary embolism, but it may be used for other pulmonary conditions, such as asthma or COPD.
b) Atropine is an anticholinergic that blocks the action of acetylcholine and increases heart rate and cardiac output. It is not indicated for treating pulmonary embolism, but it may be used for bradycardia or asystole.
d) Furosemide is a loop diuretic that increases urine output and reduces fluid volume and blood pressure. It is not indicated for treating pulmonary embolism, but it may be used for heart failure or edema.
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