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.
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Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is ["A","D"]
Explanation
These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.
b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on coughing, which is a reflex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inflammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking fluids, using a humidifier, or taking an expectorant.
c) The medication will reduce inflammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inflammatory effect on the airways, which are often inflamed and swollen in clients who have asthma or COPD. Inflammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inflammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inflammation.
e) The medication will stimulate flow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate flow of mucus, such as drinking fluids, using a humidifier, or taking an expectorant.
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