Respiratory System | Asthma & COPD NCLEX Quiz 37

Atelectasis is a condition where the air sacs in the lungs collapse or become partially blocked, leading to difficulty in breathing (dyspnea) and pain. This is because the collapsed or blocked air sacs prevent the exchange of oxygen and carbon dioxide, causing respiratory distress. Therefore, it is most likely that the nurse will find dyspnea and pain in a patient with atelectasis postoperatively.

The nurse should tell the patient that the tidal volume is the amount of air that is exhaled after there is a normal inspiration. This means that it is the volume of air that is breathed in during a normal breath and then exhaled out. It is a measure of the amount of air exchanged in each breath and can be slightly diminished in certain conditions.

Impaired tissue perfusion related to thrombosis is the correct nursing diagnosis that should be included in the plan of care because of the polycythemia. Polycythemia is a condition characterized by an increased number of red blood cells, which can lead to the formation of blood clots (thrombosis). Thrombosis can impair blood flow and cause inadequate perfusion to tissues, leading to tissue damage or dysfunction. Therefore, addressing impaired tissue perfusion is essential in the plan of care for a patient with polycythemia.

The presence of crackles in the left posterior base of the lungs indicates the possibility of fluid accumulation or congestion in the lungs, which can be a sign of pulmonary edema or heart failure. Deep breathing and coughing can help to clear the airways and improve lung function. Therefore, repeating auscultation after asking the client to deep breathe and cough would be an appropriate nursing intervention to assess for any changes in lung sounds and to promote lung clearance.

After a left pneumonectomy, the client will have undergone surgery on the left lung. To promote optimal lung expansion and prevent complications, it is common for the client to be positioned on the operative side or back. This position helps to facilitate drainage and prevent pooling of fluids in the surgical site, as well as promote lung expansion on the unaffected side. Therefore, the most likely postoperative position for the client would be the operative side or back.

The Venturi mask is the best method of oxygen administration for a client with COPD. This is because it delivers a precise and controlled amount of oxygen, allowing for a more accurate oxygen concentration to be delivered to the client. The Venturi mask also provides a high flow rate, which is important for clients with COPD who may have difficulty breathing. Additionally, the Venturi mask allows for the dilution of oxygen with room air, which helps to prevent oxygen toxicity.

The reason behind the acceleration in oxygen dissociation from hemoglobin and thus oxygen delivery to the tissues is a decreasing oxygen pressure and/or an increasing carbon dioxide pressure in the blood. This means that as the oxygen pressure decreases and/or the carbon dioxide pressure increases, the affinity of hemoglobin for oxygen decreases, allowing oxygen to be released more readily to the tissues. This helps to ensure that oxygen is delivered to the tissues where it is needed for cellular respiration.

In chronic respiratory distress, the patient may have difficulty exhaling carbon dioxide effectively, leading to a build-up of carbon dioxide in the body. This can result in respiratory acidosis, which can cause cardiac arrhythmias. The irregular pulse observed in the patient with acute bronchitis is likely due to the accumulation of carbon dioxide, leading to respiratory acidosis and subsequent cardiac arrhythmias.

Listening and feeling the air movement is the most reliable index for determining the respiratory status of a patient because it allows for direct assessment of the patient's breathing. By listening to the sounds of the patient's breath and feeling the movement of air, healthcare professionals can gather information about the rate, depth, and quality of the patient's breathing. This can help identify any abnormalities or signs of respiratory distress, such as wheezing, stridor, or decreased breath sounds, which are important indicators of the patient's respiratory status.

The first intervention in completing the tracheal suctioning procedure should be to apply oral or nasal suction. This is because suctioning helps to remove secretions and maintain a clear airway in patients with a tracheostomy. This intervention helps to prevent complications such as blockage or infection in the tracheostomy tube. Changing the tracheostomy dressing, providing humidity with a trach mask, and deflating the tracheal cuff may be necessary steps during the procedure, but they should be performed after applying oral or nasal suction.