A patient with chronic obstructive pulmonary disease (COPD) presents with dyspnea and wheezing. What is the most appropriate initial nursing intervention to manage these symptoms?

Provide oral hydration

Teach the patient pursed-lip breathing

Initiate corticosteroid therapy

Administer a short-acting beta-agonist (SABA)

Answer and Explanation

The Correct Answer is D

A. Oral hydration is important for overall health and to thin secretions, but it is not the immediate intervention to address dyspnea and wheezing in COPD.

B. Pursed-lip breathing is a helpful technique for managing chronic symptoms of COPD and improving airflow, but it is not the first step in managing acute symptoms like dyspnea and wheezing.

C. Corticosteroid therapy may be part of the treatment for COPD exacerbations, but it is not the initial intervention for acute symptoms. It is typically used after bronchodilators like SABA have been administered.

D. A short-acting beta-agonist (SABA), such as albuterol, is the first-line treatment for acute dyspnea and wheezing in COPD. It works by relaxing the bronchial muscles, opening the airways, and improving airflow.

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Correct Answer is B

Explanation

A. Continuous bubbling within the water seal chamber indicates an air leak in the system, which is not a sign of proper chest tube functioning. The nurse should investigate and address any air leaks promptly.

B. Fluctuation of the fluid level within the water seal chamber, also known as tidaling, indicates that the chest tube is functioning properly. Tidaling reflects changes in intrapleural pressure during respiration and confirms that the system is intact.

C. Absence of fluid in the drainage tubing is not an indicator of proper functioning. Depending on the client’s condition, there may or may not be fluid in the tubing. However, the system should always be assessed for patency and appropriate drainage.

D. Equal amounts of fluid drainage in each collection chamber are not expected or required. The amount of drainage depends on the client’s condition and does not indicate the functionality of the chest tube system.

A. 4L of oxygen per minute B. 2L of oxygen per minute C. 6L of oxygen per minute D. 8L of oxygen per minute

Correct Answer is B

Explanation

A. Oxygen at 4L per minute is generally too high for clients with COPD. High oxygen concentrations can suppress their hypoxic drive, which is their primary mechanism for breathing.

B. Oxygen at 2L per minute is the appropriate starting rate for clients with COPD. This flow rate provides supplemental oxygen without significantly increasing the risk of suppressing the client’s respiratory drive.

C. Oxygen at 6L per minute is excessive for clients with COPD and can lead to complications such as hypercapnia or respiratory depression.

D. Oxygen at 8L per minute is not recommended for clients with COPD unless specifically ordered in a life-threatening situation, as it can suppress their respiratory drive and worsen their condition.

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A patient with chronic obstructive pulmonary disease (COPD) presents with dyspnea and wheezing. What is the most appropriate initial nursing intervention to manage these symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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