Nokea
The nurse is performing patient education for a patient who is being discharged on mini-nebulizer treatments. What information should the nurse prioritize in the patients discharge teaching?
- A. How to count her respirations accurately
- B. How to collect serial sputum samples
- C. How to independently wean herself from treatment
- D. How to perform diaphragmatic breathing
Correct Answer: D
Rationale: Diaphragmatic breathing is a helpful technique to prepare for proper use of the small-volume nebulizer. Patient teaching would not include counting respirations and the patient should not wean herself from treatment without the involvement of her primary care provider. Serial sputum samples are not normally necessary.
You may also like to solve these questions
A nurse has performed tracheal suctioning on a patient who experienced increasing dyspnea prior to a procedure. When applying the nursing process, how can the nurse best evaluate the outcomes of this intervention?
- A. Determine whether the patient can now perform forced expiratory technique (FET)
- B. Percuss the patients lungs and thorax
- C. Measure the patients oxygen saturation
- D. Have the patient perform incentive spirometry
Correct Answer: C
Rationale: The patients response to suctioning is usually determined by performing chest auscultation and by measuring the patients oxygen saturation. FET, incentive spirometry, and percussion are not normally used as evaluative techniques.
A patient recovering from thoracic surgery is on long-term mechanical ventilation and becomes very frustrated when he tries to communicate. What intervention should the nurse perform to assist the patient?
- A. Assure the patient that everything will be all right and that remaining calm is the best strategy
- B. Ask a family member to interpret what the patient is trying to communicate
- C. Ask the physician to wean the patient off the mechanical ventilator to allow the patient to speak freely
- D. Express empathy and then encourage the patient to write, use a picture board, or spell words with an alphabet board
Correct Answer: D
Rationale: If the patient uses an alternative method of communication, he will feel in better control and likely be less frustrated. Assuring the patient that everything will be all right offers false reassurance, and telling him not to be upset minimizes his feelings. Neither of these methods helps the patient to communicate. In a patient with an endotracheal or tracheostomy tube, the family members are also likely to encounter difficulty interpreting the patients wishes. Making them responsible for interpreting the patients gestures may frustrate the family. The patient may be weaned off a mechanical ventilator only when the physiologic parameters for weaning have been met.
A patient is being admitted to the preoperative holding area for a thoracotomy. Preoperative teaching includes what?
- A. Correct use of a ventilator
- B. Correct use of incentive spirometry
- C. Correct use of a mini-nebulizer
- D. Correct technique for rhythmic breathing
Correct Answer: B
Rationale: Instruction in the use of incentive spirometry begins before surgery to familiarize the patient with its correct use. You do not teach a patient the use of a ventilator; you explain that he may be on a ventilator to help him breathe. Rhythmic breathing and mini-nebulizers are unnecessary.
The nurse is preparing to suction a patient with an endotracheal tube. What should be the nurses first step in the suctioning process?
- A. Explain the suctioning procedure to the patient and reposition the patient
- B. Turn on suction source at a pressure not exceeding 120 mm Hg
- C. Assess the patients lung sounds and SAO2 via pulse oximeter
- D. Perform hand hygiene and don nonsterile gloves, goggles, gown, and mask
Correct Answer: C
Rationale: Assessment data indicate the need for suctioning and allow the nurse to monitor the effect of suction on the patients level of oxygenation. Explaining the procedure would be the second step; performing hand hygiene is the third step, and turning on the suction source is the fourth step.
The physician has ordered continuous positive airway pressure (CPAP) with the delivery of a patients high-flow oxygen therapy. The patient asks the nurse what the benefit of CPAP is. What would be the nurses best response?
- A. CPAP allows a higher percentage of oxygen to be safely used
- B. CPAP allows a lower percentage of oxygen to be used with a similar effect
- C. CPAP allows for greater humidification of the oxygen that is administered
- D. CPAP allows for the elimination of bacterial growth in oxygen delivery systems
Correct Answer: B
Rationale: Prevention of oxygen toxicity is achieved by using oxygen only as prescribed. Often, positive end-expiratory pressure (PEEP) or CPAP is used with oxygen therapy to reverse or prevent microatelectasis, thus allowing a lower percentage of oxygen to be used. Oxygen is moistened by passing through a humidification system. Changing the tubing on the oxygen therapy equipment is the best technique for controlling bacterial growth.