The nurse is reviewing the results of laboratory and diagnostic ...

[jho37]

The nurse is reviewing the results of laboratory and diagnostic tests conducted on a patient experiencing respiratory dysfunction. Which results confirm the nurse's suspicion that the patient has cystic fibrosis?
 
  Select all that apply.
 
  1. patchy infiltrates on chest x-ray
  2. mediastinal shift on chest CT scan
  3. oxygen saturation 82 on room air
  4. chloride concentration of sweat 85 mEq/L
  5. reduced total lung capacity from pulmonary function test

Question 2

The nurse instructs a patient with chronic obstructive pulmonary disease (COPD) on the huff cough technique. Which observations indicate that teaching has been effective?
 
  Select all that apply.
 
  1. The patient coughs twice.
  2. The patient leans forward.
  3. The patient makes a huff sound when exhaling.
  4. The patient inhales through the nose with the mouth closed.
  5. The patient places one hand on the abdomen and the other on the chest.

[nyrave]

Answer to Question 1

Correct Answer: 3, 4, 5
Cl concentration in sweat is analyzed to confirm the diagnosis of cystic fibrosis. In CF, the Cl concentration is > 70 mEq/L. ABGs and oxygen saturation levels show hypoxemia. Pulmonary function studies reveal reduced total lung capacity. Patchy infiltrates on chest x-ray would be associated with pneumonia. Mediastinal shift on chest CT scan is consistent with a tension pneumothorax.

Answer to Question 2

Correct Answer: 2, 3
For huff coughing, the patient should be instructed to inhale deeply while leaning forward and to exhale sharply with a huff sound, to help keep airways open while mobilizing secretions. Coughing twice is part of the controlled coughing technique. Inhaling through the nose with the mouth closed is part of the pursed-lip technique. Placing one hand on the abdomen and the other on the chest is part of the diaphragmatic breathing technique.