1
Respiratory Syncytial Virus (RSV)
Bronchiolitis HESI CASE STUDY:
Questions and Answers (100% Correct
Answers) Already Graded A+
What action should the nurse take next? Ans:
Continue respiratory assessment.
© 2025 Assignment
The nurse should complete the respiratory
Guru01 - Stuvia
assessment, as this will provide important
baseline information for the healthcare provider
Expert
(HCP).
Which techniques should the nurse use to assess
for respiratory distress? Ans: Place a pulse
oximeter on a big toe of the baby's foot.
The nurse should use a pulse oximeter to
measure the infant's oxygen saturation level. A
decreased oxygen saturation level is a sign of
respiratory compromise. The foot is the
preferred site for a pulse oximeter because
infants are apt to scratch themselves with the
probe if it is placed on the hand. Fingers are not
used because they are too small to support the
probe. The infant's foot should be kept warm,
with a sock if necessary, to ensure accurate
measurement.
, 2
Inspect the chest wall for symmetry and
retractions.
Respiratory distress can be seen as an
asymmetrical chest wall expansion, intercostal
retractions, and nasal flaring.
Count the infant's pulse and respiratory rates.
© 2025 Assignment
Tachycardia and tachypnea can both be signs of
Guru01 - Stuvia
respiratory distress.
Expert
The nurse continues the assessment. Which
assessment finding exhibited by Emma warrants
immediate intervention by the nurse? Ans:
minimal response to stimuli
- A change in the infant's level of consciousness
is a significant indicator of poor oxygenation
and requires immediate intervention by the
nurse.
A nursing student is precepting with Emma's
primary nurse. The nurse asks the student about
signs and symptoms of respiratory distress.
Which findings should the nurse confirm is a
sign of worsening shortness of breath for the
client? Ans: Nasal flaring.
Respiratory Syncytial Virus (RSV)
Bronchiolitis HESI CASE STUDY:
Questions and Answers (100% Correct
Answers) Already Graded A+
What action should the nurse take next? Ans:
Continue respiratory assessment.
© 2025 Assignment
The nurse should complete the respiratory
Guru01 - Stuvia
assessment, as this will provide important
baseline information for the healthcare provider
Expert
(HCP).
Which techniques should the nurse use to assess
for respiratory distress? Ans: Place a pulse
oximeter on a big toe of the baby's foot.
The nurse should use a pulse oximeter to
measure the infant's oxygen saturation level. A
decreased oxygen saturation level is a sign of
respiratory compromise. The foot is the
preferred site for a pulse oximeter because
infants are apt to scratch themselves with the
probe if it is placed on the hand. Fingers are not
used because they are too small to support the
probe. The infant's foot should be kept warm,
with a sock if necessary, to ensure accurate
measurement.
, 2
Inspect the chest wall for symmetry and
retractions.
Respiratory distress can be seen as an
asymmetrical chest wall expansion, intercostal
retractions, and nasal flaring.
Count the infant's pulse and respiratory rates.
© 2025 Assignment
Tachycardia and tachypnea can both be signs of
Guru01 - Stuvia
respiratory distress.
Expert
The nurse continues the assessment. Which
assessment finding exhibited by Emma warrants
immediate intervention by the nurse? Ans:
minimal response to stimuli
- A change in the infant's level of consciousness
is a significant indicator of poor oxygenation
and requires immediate intervention by the
nurse.
A nursing student is precepting with Emma's
primary nurse. The nurse asks the student about
signs and symptoms of respiratory distress.
Which findings should the nurse confirm is a
sign of worsening shortness of breath for the
client? Ans: Nasal flaring.
