A patient with asthma is admitted with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding would the nurse expect?

Peak flow of more than 40%

Bradycardia

Loud and prominent wheezing

Arterial blood gas is deteriorating

Answer and Explanation

The Correct Answer is D

A. A peak flow of more than 40% would indicate that the patient's asthma is not in an acute exacerbation. This patient's symptoms, such as confusion and inability to speak, suggest a severe asthma attack, and the peak flow would likely be much lower.
B. Bradycardia is not typically associated with severe asthma exacerbations. Tachycardia is more commonly observed as the body attempts to compensate for hypoxia.
C. Loud and prominent wheezing is usually seen in less severe cases of asthma. In this case, the inability to speak and confusion suggest severe respiratory distress, where wheezing might be diminished or absent due to poor air movement.
D. Deteriorating arterial blood gas (ABG) results, with low oxygen levels (hypoxemia) and elevated carbon dioxide levels (hypercapnia), would be expected in a patient with severe asthma exacerbation. These signs indicate respiratory failure and the need for urgent intervention.

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Correct Answer is D

Explanation

A. Blood glucose levels are not directly affected by desmopressin, as it is used to treat diabetes insipidus, which is related to antidiuretic hormone (ADH) deficiency, not glucose metabolism.
B. A serum sodium level of 146 mEq/L is slightly elevated and may indicate dehydration, which is common in diabetes insipidus if not well controlled. Desmopressin should help lower the sodium level by reducing the excessive urine output.
C. Blood urea nitrogen (BUN) is typically used to assess kidney function and hydration status, but it is not a primary indicator of the effectiveness of desmopressin in treating diabetes insipidus.
D. A urine specific gravity of 1.015 is within the normal range and indicates more concentrated urine, which is a therapeutic effect of desmopressin. The medication helps the kidneys retain water, leading to more concentrated urine, and improving symptoms of diabetes insipidus.

A. Restrict fluid intake. B. Administer oral corticosteroids. C. Provide a low-carbohydrate diet. D. Weigh the client daily.

Correct Answer is B

Explanation

A. Restrict fluid intake: This is incorrect. Clients with Addison’s disease are at risk for dehydration, especially during an Addisonian crisis. Fluids should be encouraged to help maintain blood pressure and fluid balance, rather than restricting fluid intake.
B. Administer oral corticosteroids: This is the correct action. Clients with Addison's disease have insufficient cortisol production, especially during times of stress or illness. Oral corticosteroids, such as hydrocortisone, are given to replace the deficient hormones and prevent or manage an Addisonian crisis.
C. Provide a low-carbohydrate diet: This is incorrect. Clients with Addison’s disease should have a balanced diet that includes adequate carbohydrates to support energy needs, especially during stress or illness. A low-carbohydrate diet could lead to further complications like hypoglycemia.
D. Weigh the client daily: While daily weight measurements can be helpful in monitoring for fluid retention or loss, it is not a primary intervention for preventing or managing Addisonian crisis. The most critical action is providing the necessary corticosteroid replacement therapy.

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A patient with asthma is admitted with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding would the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which of the following laboratory findings indicate a therapeutic effect of the medication?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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