The patient with emphysema comes to the emergency department with difficulty breathing. What finding should the nurse anticipate during data collection? Select all that apply
diminished breath sounds
ruddy skin color
use of accessory muscles
excess mucus production
barrel shaped chest
Correct Answer : A,C,E
A. Diminished breath sounds can occur in emphysema due to decreased air movement through damaged and enlarged air sacs (alveoli). The destruction of alveolar walls reduces the surface area available for gas exchange and can result in decreased breath sounds.
C. Patients with emphysema may use accessory muscles, such as neck and shoulder muscles, to assist with breathing during periods of respiratory distress. These muscles are recruited to help increase the size of the thoracic cavity and improve airflow.
E. A barrel-shaped chest is a common physical finding in patients with emphysema. It results from hyperinflation of the lungs and is characterized by an increased anterior-posterior diameter of the chest. This change in chest shape is due to air trapping in the lungs, leading to overinflation of the alveoli and increased residual volume.
B. Ruddy skin color, which refers to a reddish or flushed complexion, is not typically associated with emphysema. Instead, patients with emphysema may exhibit cyanosis (bluish discoloration of the skin) during periods of hypoxemia (low oxygen levels).
D. Excess mucus production (mucus hypersecretion) is a characteristic feature of chronic bronchitis, which is often present alongside emphysema in chronic obstructive pulmonary disease (COPD) but it is not typically a primary feature of emphysema itself.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. The spacer helps to deliver more medication to the lungs by holding the medication in the chamber, allowing the patient to inhale it more slowly and deeply. This results in better deposition of the medication in the lower airways and reduces the amount of medication that is deposited in the mouth and throat.
A. The primary purpose of the spacer is to increase the amount of medication that reaches the lungs and to reduce the amount deposited in the oropharynx (throat). The spacer helps to ensure that more medication is delivered directly to the airways where it is needed, thereby enhancing the effectiveness of the treatment and reducing side effects.
B. The exhalation slots or vents on a spacer are designed to allow the patient to exhale easily without removing the device from the mouth. The lips should form a tight seal around the mouthpiece of the spacer to ensure effective inhalation, but the exhalation slots should not be intentionally covered.
D. When using a spacer with an MDI, the patient should inhale slowly and deeply. Rapid inhalation can cause the medication to be deposited in the upper airways rather than reaching the lungs. A slow and deep inhalation allows for better medication delivery to the lower airways.
Correct Answer is C
Explanation
C. Elevating the head of the bed can help reduce nighttime GERD symptoms. By elevating the head of the bed by about 6 to 8 inches (15 to 20 centimeters), gravity helps prevent stomach acid from refluxing into the esophagus while the individual is lying down. This position can alleviate symptoms such as heartburn, regurgitation, and coughing during sleep.
A. Alcohol consumption, especially before bedtime, can exacerbate GERD symptoms. Alcohol relaxes the lower esophageal sphincter (LES), allowing stomach acid to reflux into the esophagus more easily.
B. Sleeping on the stomach with the head flat can worsen GERD symptoms. This position can increase pressure on the stomach and promote reflux of stomach acid into the esophagus. Sleeping on the stomach is generally not recommended for individuals with GERD.
D. Eating a large meal or having a snack shortly before bedtime can increase the likelihood of GERD symptoms during sleep. It's generally recommended to avoid eating large meals or heavy snacks close to bedtime. Instead, individuals with GERD should aim to finish eating at least 2 to 3 hours before lying down to sleep.
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