A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.)

Dyspnea

Barrel chest

Clubbing of the fingers

Shallow respirations

Bradycardia

Answer and Explanation

Correct Answer : A,B,D

A. Dyspnea: Dyspnea is a hallmark symptom of emphysema. As lung function deteriorates, the client experiences difficulty breathing, especially during exertion, due to reduced gas exchange and air trapping in the lungs.

B. Barrel chest: A barrel chest is a common finding in emphysema due to hyperinflation of the lungs over time. This causes the chest to become rounded and expands the anterior-posterior diameter of the thorax.

C. Clubbing of the fingers: Clubbing of the fingers is not a typical finding in emphysema or COPD. It is more commonly associated with conditions like lung cancer, cystic fibrosis, or congenital heart disease, where chronic severe hypoxia is present.

D. Shallow respirations: Clients with emphysema often exhibit shallow respirations as their lung elasticity decreases, making it difficult to fully exhale. As a result, breathing may become more rapid and shallow to compensate for poor oxygen exchange.

E. Bradycardia: Bradycardia is not typically associated with emphysema. Instead, clients with chronic respiratory conditions like emphysema may experience tachycardia as the body tries to compensate for low oxygen levels.

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Correct Answer is B

Explanation

A. Prone with arms raised over the head.

This position involves lying face down with the arms raised over the head. It is not appropriate for thoracentesis because it does not provide easy access to the thoracic cavity, and it may compress the chest, making it difficult for the client to breathe comfortably during the procedure.

B. Sitting, leaning forward over the bedside table.

This is the correct choice. For thoracentesis, the client should be positioned sitting upright and leaning forward over the bedside table or supported by pillows. This position allows better access to the thoracic cavity and facilitates the removal of pleural fluid. Leaning forward also helps to open up the intercostal spaces, making it easier for the healthcare provider to insert the needle into the appropriate space between the ribs.

C. High Fowler's position.

The High Fowler's position involves the client sitting upright with the head of the bed elevated at a 90-degree angle. While this position may be used for other respiratory procedures or for comfort, it is not the optimal position for thoracentesis. It does not provide the same degree of access to the thoracic cavity as the sitting position with forward leaning.

D. Side-lying with knees drawn up to the chest.

This position involves lying on one side with the knees drawn up to the chest. It is not appropriate for thoracentesis because it does not provide access to the thoracic cavity, and it may obstruct the procedure. Additionally, this position may not be comfortable for the client during the procedure.

A. Fatigue B. High fever in the early morning C. Edema D. Increased appetite

Correct Answer is A

Explanation

A. Fatigue

When collecting data from a client with pulmonary tuberculosis (TB), the nurse should expect to observe fatigue as one of the common manifestations. TB is a bacterial infection caused by Mycobacterium tuberculosis, primarily affecting the lungs. Fatigue is a typical symptom experienced by individuals with TB, often resulting from the body's immune response to the infection, as well as the systemic effects of inflammation and tissue damage caused by the bacteria.

B. High fever in the early morning

While fever is a symptom of tuberculosis, it may not necessarily occur specifically in the early morning. Fever associated with TB can occur at any time of the day and may persist for weeks to months. The pattern of fever can vary among individuals and may not consistently occur in the early morning.

C. Edema

Edema, or swelling due to fluid accumulation in tissues, is not typically associated with pulmonary tuberculosis. Edema is more commonly observed in conditions such as heart failure, renal failure, or liver disease, rather than in TB.

D. Increased appetite

Increased appetite is not a typical finding in pulmonary tuberculosis. In fact, individuals with active TB infection often experience appetite loss and unintended weight loss due to factors such as decreased food intake, metabolic changes, and systemic inflammation associated with the infection.

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A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.)

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