The nurse reviews the client 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.
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 couldn't 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 client reports using a rescue inhaler three times, but he just couldn't catch his breath
symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous
inhaler was expired and was worried the medication was not working
able to answer questions, pausing every few words to catch his breath
The client reports that it has been a couple of months since he had an asthma attack
The Correct Answer is ["A","B"]
In the provided scenario, the two key pieces of subjective data indicating the need for health interventions are the client's report of using a rescue inhaler multiple times without relief and the exacerbation of symptoms when outdoors and during exercise. These details suggest that the client's asthma is not well-controlled, and the ineffectiveness of the rescue medication, especially with an expired inhaler, warrants immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}
Explanation
Correct Answers:
Indicates the Interventions Were Successful: A, B, C, D, E, F
No Indication that the Interventions Were Successful: None
Rationale:
The assessment data provided indicates a positive response to the interventions for the asthma attack. The decrease in heart rate from 112 to 105 beats per minute, alongside the client's ability to speak in full sentences without pausing, suggests an improvement in respiratory function. Clear lung sounds and a reduction in respiratory rate to 16 breaths per minute further support this conclusion. The client's subjective report of eased breathing and the maintenance of blood pressure within normal limits post-intervention are also indicative of successful treatment. These observations collectively demonstrate the effectiveness of the administered medications and oxygen therapy in managing the acute asthma symptoms presented by the client.
Correct Answer is A
Explanation
A. Crohn's disease with colectomy. Peritoneal dialysis involves instilling dialysis fluid into the peritoneal cavity, and conditions that affect the integrity or function of the peritoneum, such as Crohn's disease with colectomy, can be contraindications due to the risk of infection or inadequate dialysis.
B. Latent hepatitis C is not a contraindication for peritoneal dialysis, although active hepatitis C infection may be a concern due to increased risk of peritonitis.
C. Type 2 diabetes mellitus is not a contraindication for peritoneal dialysis; in fact, it is a common cause of end-stage renal disease and may necessitate dialysis.
D. Nephrotic syndrome history is not a contraindication for peritoneal dialysis; in fact, peritoneal dialysis may be indicated in some cases of renal failure associated with nephrotic syndrome.
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