A nurse is collecting data from a client who has a respiratory disorder and displays manifestations of hypoxia. Which of the following findings should the nurse expect?
Bradypnea
Cyanosis
Pallor
Bradycardia
The Correct Answer is B
A. Bradypnea, or abnormally slow breathing, is not typically associated with hypoxia. Hypoxia usually triggers an increase in respiratory rate (tachypnea) as the body attempts to take in more oxygen to meet its needs.
B. Cyanosis, a bluish discoloration of the skin and mucous membranes, is a key sign of hypoxia. It occurs when there is insufficient oxygen in the blood, leading to a darker color of deoxygenated hemoglobin. Cyanosis is most commonly observed in the lips, fingertips, and toes.
C. Pallor, or paleness of the skin, can occur in various conditions but is not specific to hypoxia. It is more commonly associated with anemia or shock rather than low oxygen levels in the blood.
D. Bradycardia, or a slower-than-normal heart rate, is not typically a manifestation of hypoxia. Instead, hypoxia often causes tachycardia as the body attempts to increase oxygen delivery to tissues by pumping blood more quickly.
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Related Questions
Correct Answer is C
Explanation
A. Respiratory alkalosis: Respiratory alkalosis is more commonly associated with hyperventilation and is not directly linked to the physiological effects of a tension pneumothorax, where the primary concern is intrathoracic pressure changes.
B. Increased venous return: In tension pneumothorax, intrathoracic pressure increases significantly, compressing the great vessels and the heart, leading to decreased venous return, not an increase.
C. Decreased cardiac output: Tension pneumothorax causes a rise in intrathoracic pressure, which compresses the heart and great vessels, leading to decreased venous return and, consequently, reduced cardiac output. This is a critical finding and requires immediate intervention.
D. Dilated ventricles: Ventricular dilation is generally associated with chronic heart conditions, not acute issues like tension pneumothorax, where decreased filling pressures are more of a concern than dilation.
Correct Answer is A
Explanation
A. Bronchospasm occurs when there is inflammation, edema, and excess mucus: Bronchospasm in asthma is characterized by inflammation of the airways, edema of the airway walls, and increased mucus production, leading to constriction and obstruction of the airways.
B. Decreased mucus production contributes to airway constriction: In asthma, bronchospasm is associated with increased mucus production, not decreased. Excess mucus contributes to airway obstruction.
C. Inflammation is reduced due to airway diameter: Inflammation typically increases airway constriction rather than reducing it. The narrowed airway diameter is a result of inflammation, not a reduction in inflammation.
D. Airway obstruction occurs due to thinning mucus: Airway obstruction in asthma is due to thick, tenacious mucus, not thinning mucus. The mucus contributes to the blockage of the airways.
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