Nokea
A long-term COPD client is receiving oxygen at 1 L/minute. Her visiting cousin decides she "doesn't look too good" and increases her oxygen to 7 L/minute. What should the nurse's initial action be?
- A. Thank the client's cousin and continue to observe the client.
- B. Immediately decrease the oxygen.
- C. Notify the physician.
- D. Elevate the client's head and take vital signs.
Correct Answer: B
Rationale: The correct answer is B: Immediately decrease the oxygen. Increasing oxygen without physician's order can lead to oxygen toxicity in COPD patients. Step-by-step rationale: 1. Assess the client's condition. 2. Determine the client's baseline oxygen therapy. 3. Recognize that sudden increase in oxygen can suppress the respiratory drive in COPD patients. 4. Decrease oxygen to the prescribed level. Summary: A: Inadequate response, as oxygen adjustment is necessary. C: Not immediate action, physician notification can follow. D: Pertinent to assess, but not the initial action needed in this scenario.
You may also like to solve these questions
When Bohr effect occurs due to increased CO2 tension, Oxygen affinity of Hb decreases. The reason for increased CO2 tension is
- A. Increase in P50
- B. Decrease in P50
- C. High CO2 content
- D. High O2 content
Correct Answer: A
Rationale: The correct answer is A because an increase in P50 indicates a decrease in oxygen affinity of hemoglobin (Hb), as seen in the Bohr effect. When CO2 tension rises, it forms carbonic acid in the blood, leading to a decrease in pH. This decrease in pH causes a right shift in the oxygen-hemoglobin dissociation curve, resulting in lower oxygen affinity of Hb. Decreasing P50 reflects this reduced affinity. Choices B, C, and D are incorrect because a decrease in P50, high CO2 content, and high O2 content would not lead to a decrease in oxygen affinity as observed in the Bohr effect.
Which statement is false about anatomical dead space?
- A. Anatomical dead space varies with age
- B. Can be estimated by the Fowlers method
- C. Significantly large in shallow breathing
- D. Measured by plotting N2 concentration against expired volume as in Bohr’s method
Correct Answer: D
Rationale: The correct answer is D because Bohr's method measures physiological dead space, not anatomical dead space. Anatomical dead space is constant and not affected by N2 concentration. A: Anatomical dead space does vary with age due to changes in lung dimensions. B: Fowlers method estimates anatomical dead space by measuring tidal volume and respiratory rate. C: Anatomical dead space is not significantly large in shallow breathing as it mainly involves the conducting airways, not the alveoli.
You are providing care for a client with recently diagnosed asthma. What key points will you be sure to include in your teaching plan for this client? (Choose all that apply.)
- A. Avoid potential environmental asthma triggers such as smoke.
- B. Use inhaler 30 minutes before exercising to prevent bronchospasm.
- C. Wash all bedding in cold water to reduce and destroy dust mites.
- D. Be sure to get at least 8 hours of rest and sleep every night.
Correct Answer: D
Rationale: The correct answer includes A, B, and D. Avoiding triggers (A), using inhalers before exercise (B), and ensuring adequate rest (D) are important for asthma management. Washing bedding in cold water (C) is ineffective for destroying dust mites; hot water is required.
Which of the following factors would decrease the amount of oxygen discharged by hemoglobin to peripheral tissues?
- A. increased temperature
- B. decreased pH
- C. decreased tissue PO2
- D. decreased amounts of BPG
Correct Answer: D
Rationale: The correct answer is D: decreased amounts of BPG. BPG binds to hemoglobin, reducing its affinity for oxygen. Without BPG, hemoglobin holds onto oxygen tightly, decreasing its release to tissues. Increased temperature (choice A) and decreased pH (choice B) actually enhance oxygen release by hemoglobin through the Bohr effect. Decreased tissue PO2 (choice C) triggers hemoglobin to release more oxygen due to the oxygen-hemoglobin dissociation curve.
Which statement by a patient with newly diagnosed heart failure indicates to the nurse that the teaching was effective?
- A. I will call the clinic if my weight goes up 3 pounds in a week.
- B. I will take furosemide (Lasix) every day just before bedtime.
- C. I will use the nitroglycerin patch whenever I have chest pain.
- D. I will weigh myself every week with the same scale.
Correct Answer: A
Rationale: The correct answer is A because it demonstrates understanding of monitoring for fluid retention, a common issue in heart failure. Calling the clinic if weight increases by 3 pounds in a week allows for early intervention. Choice B is incorrect because taking furosemide at bedtime may disrupt sleep and increase nighttime urination. Choice C is incorrect as nitroglycerin is for acute chest pain, not a preventative measure. Choice D is incorrect because weighing weekly may not catch sudden weight changes that indicate worsening heart failure.