Patient Data

History and Physical

A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just could not catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
The nurse reviews the client's history of the presenting illness in the electronic medical record.

Click to highlight the two pieces of key subjective data which indicate the client is in need of health interventions.

The client reports using a rescue inhaler three times, but he just could not catch his breath

The client reports that symptoms seem worse when outdoors and when exercising

episodes like this make him extremely nervous

it has been a couple of months since he had an asthma attack

noticed that his inhaler was expired and was worried the medication was not working

Answer and Explanation

The Correct Answer is ["A"]

Subjective data refers to the symptoms reported by the client while objective data refers to the information collected on assessment of the client. During asthmatic attack, the client reports of shortness of breath, audible wheezing, inability to speak in complete sentences and a feeling of nervousness.

The use of a reliever without relief during an asthmatic attack indicates the severity of the attack. This requires intervention including the introduction of inhaled corticosteroids to reduce airway inflammation and remodeling.

The recurrence of symptoms on exposure to exercise requires the need for further advise to avoid triggers and recurrence of symptoms.

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Free Nursing Study Resources

Correct Answer is {"A":{"answers":"A, E"},"B":{"answers":"C, E"},"C":{"answers":"C, E"},"D":{"answers":"D, G"}}

Explanation

Colchicine is used in severe acute gout attack to minimize pain at the joint. Colchicine's mechanism of action involves interfering with the inflammatory process by binding to tubulin, a protein essential for the formation of microtubules within cells.

Prednisone is a corticosteroid with anti-inflammatory properties. It reduces inflammation caused by urate crystals.

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID). It interferes with the inflammatory process in gout reducing pain. The use of naproxen and prednisone with alcohol reduces their effectiveness leading to suboptimal pain relief.

Allopurinol is a lipid lowering agent. It prevents the formation of uric acid lowering the deposition of urate crystals at the joint(s). Missing a dose of allopurinol leads to subtherapeutic blood levels and increased risk of acute gout attacks.

A. Remove the medication from the dispensing system. B. Compare the client’s wristband to the medication administration record. C. Document administration of the medication. D. Open the medication package. E. Obtain the client’s apical heart rate.

Correct Answer is E, A, B, D, C

Explanation

Before administering digoxin, the nurse should check the patient's apical heart rate. If the heart rate is below 60 beats per minute for an adult, or below the prescribed limit for a child, the nurse should hold the medication and notify the healthcare provider. This is the first step because the nurse needs to have the medication in hand before proceeding with the other steps. This step is crucial to ensure that the right medication is being given to the right patient. It's a part of the "five rights" of medication administration: right patient, right medication, right dose, right route, and right time. Once the nurse has confirmed the patient's identity and heart rate, the next step is to open the medication package. After administering the medication, the nurse should document it in the patient's medical record. This is important for maintaining an accurate record of the patient's medication history.

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Naxlex Comprehensive Predictor Exams

Patient Data Exhibits For each medication used to treat gout, choose the most likely therapeutic outcome and the teaching associated with the medication.

Correct Answer is {"A":{"answers":"A, E"},"B":{"answers":"C, E"},"C":{"answers":"C, E"},"D":{"answers":"D, G"}}

Explanation

A nurse is preparing to administer digoxin orally to a client. Identify the sequence of steps the nurse should take (Move the steps into the box on the right, placing them in the order of performance. Use all the steps)

Correct Answer is E, A, B, D, C

Explanation

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