Chapter 11: PrepU - Nursing Management of patients with COPD

Chapter 11: PrepU - Nursing Management of patients with COPD A nurse administers albuterol (Proventil), as ordered, to a client with emphysema. Which finding indicates that the drug is producing a therapeutic effect? Respiratory rate of 22 breaths/minute Dilated and reactive pupils Urine output of 40 ml/hour Heart rate of 100 beats/minute - ANS- 1 A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client? Full-liquid High-protein 1,800-calorie ADA Low-fat - ANS- 2 To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations? Streptococcus pneumonia and Haemophilus influenzae Streptococcus pneumonia and varicella Haemophilus influenzae and varicella Haemophilus influenzae and Gardasil - ANS- 1 A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? Chest pain during respiration Sputum and a productive cough Fever, chills, and diaphoresis Tachypnea and tachycardia - ANS- 2 A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 65% for a patient with COPD. What stage should the nurse document the patient is in? I II III IV - ANS- 2 A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one disorder within its classification. Which of the following is that disorder? Asthma Bronchiectasis Cystic fibrosis Emphysema - ANS- 4 Asthma is a chronic illness and requires life-long management by patients and clinicians to achieve the goals of therapy. The signs and symptoms of this disease are primarily attributable to what pathophysiological process? Acute inflammation of the patient's hyperresponsive airway Hypersecretion of mucus by goblet cells in the upper airway Misinterpretation of chemoreceptor signals by the pons and medulla Autoimmune destruction of the mucosa in the patient's upper airway - ANS- 1 The classification of Stage II of COPD is defined as at risk for COPD. moderate COPD. severe COPD. very severe COPD. mild COPD. - ANS- 2 A nurse is reviewing the medical records of several clients who have been diagnosed with COPD. When reviewing pulmonary function test results, the client with which postbronchodilator FEV1/FVC result would be considered to have the most severe disease? 70% 68% 65% 63% - ANS- 4 A client with COPD is being referred to a pulmonary rehabilitation program. When explaining this program to the client, which information would the nurse most likely include as a reason for it? Select all that apply. symptom reduction improved quality of life reduction in disease progression greater participation in activities lessened need for medication therapy - ANS- 1, 2, 4 A client with chronic obstructive pulmonary disease (COPD) is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should: instruct the client to drink at least 2 L of fluid daily. maintain the client on bed rest. administer anxiolytics, as ordered, to control anxiety. administer pain medication as ordered. - ANS- 1 The nurse is performing an admission assessment of a patient who has a history of asthma. The nurse should be aware that the most common signs of asthma are what? Shallow respirations Increased A-P diameter Bilateral wheezes Rhonchi in the lower bases - ANS- 3 The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) and is now performing discharge teaching with this patient. What should the nurse include in the teaching about breathing techniques? Make inhalation longer than exhalation. Exhale through a wide open mouth. Use diaphragmatic breathing. Use chest breathing. - ANS- 3 A resident of a long-term care facility has lived with chronic obstructive pulmonary disease (COPD) for many years but has experienced a gradual increase in dyspnea despite the use of long-term oxygen therapy. In recent weeks, dyspnea has interfered with the resident's ability to eat, and the nurse recognizes the potential nursing diagnosis of altered nutrition: less than body requirements. How can the nurse best foster this resident's nutritional status? Arrange for a high-protein diet to promote gas exchange. Provide meals early in the morning and late at night. Liaise with the resident's health care provider to organize total parenteral nutrition (TPN). Order small, frequent meals and nutritional supplements for the resident. - ANS- 4...