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Patient Data

Exhibits

What finding(s) are cues for a respiratory problem? Select all that apply.

Sitting upright

Tightness in the chest

Medication compliance

Respirations of 28 breaths/minute

Restlessness

Dyspnea

Pulse oxygenation of 85%

Answer and Explanation

Correct Answer : A,B,D,E,F,G

A.   Patients with respiratory distress often prefer to sit upright or in a tripod position to ease breathing by allowing maximal lung expansion. Sitting upright helps relieve pressure on the diaphragm and allows better air exchange in the lungs.
B.   Chest tightness is a common symptom of various respiratory conditions, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia. It can result from bronchoconstriction, inflammation, or accumulation of mucus in the airways, leading to difficulty breathing.
D.   An increased respiratory rate (tachypnea) may indicate respiratory distress or difficulty breathing. Tachypnea is a compensatory mechanism to increase oxygen intake or remove carbon dioxide from the body when lung function is compromised.
E.   Restlessness can be a cue for a respiratory problem. Patients experiencing respiratory distress may exhibit restlessness due to hypoxia (low oxygen levels), discomfort, or anxiety related to difficulty breathing.
F.   Dyspnea, or shortness of breath, is a significant cue for a respiratory problem. It is a common symptom of various respiratory conditions, including asthma, COPD, pneumonia, and pulmonary embolism. Dyspnea may range from mild to severe and can significantly impact the patient's quality of life and functional status.
G.   A pulse oxygenation level of 85% indicates hypoxemia (low blood oxygen levels) and is a significant cue for a respiratory problem. Hypoxemia can result from various respiratory conditions or inadequate ventilation and may lead to tissue hypoxia and organ dysfunction if left untreated.
C. Medication compliance is not directly indicative of a respiratory problem. However, it may be relevant to managing respiratory conditions if the patient requires medications such as bronchodilators or corticosteroids to control symptoms or prevent exacerbations.
H. While an elevated heart rate (tachycardia) can be associated with respiratory distress, it is not specific to respiratory problems and may occur in response to other stressors or medical conditions.
I. Body mass index (BMI) is a measure of body fat based on height and weight and is not directly indicative of a respiratory problem. However, obesity is a risk factor for respiratory conditions such as obstructive sleep apnea and obesity hypoventilation syndrome.

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Correct Answer is C

Explanation

C. Elevating the head of the bed to 90 degrees (semi-Fowler's position) can help improve respiratory mechanics and lung expansion, making breathing easier for the client. This position can also help reduce the risk of aspiration and improve oxygenation in clients with respiratory distress.
A. Identifying and addressing triggers that exacerbate asthma symptoms is crucial for managing asthma effectively. By determining the client's exposure to triggers such as allergens, pollutants, or irritants, the nurse can help prevent future asthma exacerbations and tailor the client's management plan accordingly. However, this is done after the client is stabilized.
B. While teaching proper inhaler technique is an essential aspect of asthma management, the priority in this scenario is addressing the client's immediate respiratory distress. The client is already receiving a steroid nebulizer treatment, which is aimed at providing rapid relief and improving lung function. Teaching proper inhaler technique can be addressed later once the client's respiratory distress is stabilized.
D. While monitoring pulse oximetry is essential for assessing oxygenation and respiratory status, the frequency of monitoring may need to be increased in a client with asthma in respiratory distress. Clients experiencing respiratory distress may have rapid changes in oxygen saturation levels, necessitating more frequent monitoring to ensure timely intervention if oxygenation deteriorates.

A. Fasting blood sugar of 200 mg/dl. (11.1 mmol/L). B. Serum creatinine of 1.9 mg/dl. (168 μmol/l) C. Glycosylated hemoglobin of 8%. D. Blood urea nitrogen of 22 mg/dL (7.9 mmol/L)

Correct Answer is B

Explanation

B. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. Elevated serum creatinine levels may indicate impaired kidney function. Since contrast agents can affect renal function, a serum creatinine level above the reference range should be reported to the healthcare provider before the MRI with contrast.

A. While elevated blood sugar levels may indicate diabetes or poor glycemic control, they are not directly related to kidney function or the risk of contrast-induced nephropathy. Therefore, this value is not the most pertinent for reporting before an MRI with contrast.
C.Glycosylated hemoglobin (HbA1c) reflects average blood glucose levels over the past two to three months and is used to assess long-term glycemic control in diabetes. While elevated HbA1c levels suggest poor diabetes management, they do not directly assess kidney function or the risk of contrast-induced nephropathy.
D. Blood urea nitrogen (BUN) levels reflect the amount of urea nitrogen in the blood and can indicate kidney function. Elevated BUN levels may suggest impaired renal function. However, an elevated serum creatinine is a more reliable marker for renal excretion.

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Patient Data Exhibits What finding(s) are cues for a respiratory problem? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After initiating a steroid nebulizer treatment for a client with asthma in respiratory distress, which intervention is most important for the nurse to implement?

Correct Answer is C

Explanation

Correct Answer is B

Explanation

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Patient Data

Exhibits

What finding(s) are cues for a respiratory problem? Select all that apply.