NUR 242 Exam 3 Study Guide Unit 7 & 8: Questions & Answers: Latest Updated

The patient is in the ICU for 3 days and then transferred back to the pulmonary stepdown unit. She is still slightly short of breath with exertion. Her O2 saturation is 99% on oxygen at 2 L per nasal cannula. She denies any shortness of breath when resting during the assessment. The provider plans to discharge the patient on home oxygen in the morning. What should the nurse include in this patient's discharge teaching? (- ANS: Make sure that the patient understands any new medication regimen. She should be instructed to call 911 for any severe respiratory distress. Because she is being discharged with home oxygen, home health services should be arranged. A patient with COPD presents for a routine follow up. The patient smokes 1 PPD. Which statement by the patient causes the nurse to suspect an increase in dyspnea? A. "I bought a new pillow so I could prop myself up at night to sleep." B. "I have a productive cough in the morning." C. "I have gained weight since I was here last." D. "The patient is well groomed and is sitting in a tripod position." (- ANS: A Patients with COPD, who smoke, may have a productive morning cough. Weight loss often occurs when dyspnea is increased due to the increased metabolic demand. A tripod or orthopneic position is common with COPD and when combined with a disheveled appearancemay indicate an increase in dyspnea. Buying a new pillow indicates that the patient must sleep propped up because breathing is worse while lying down. They may not recognize the increased dyspnea and they try to compensate by using multiple pillows in order to rest.