A nurse cares for a client with chronic obstructive pulmonary ...

[khang]

A nurse cares for a client with chronic obstructive pulmonary disease (COPD) who appears thin and disheveled. Which question should the nurse ask first?
 
  a. Do you have a strong support system?
  b. What do you understand about your disease?
  c. Do you experience shortness of breath with basic activities?
  d. What medications are you prescribed to take each day?

Question 2

A nurse cares for a client who has a chest tube. When would this client be at highest risk for developing a pneumothorax?
 
  a. When the insertion site becomes red and warm to the touch
  b. When the tube drainage decreases and becomes sanguineous
  c. When the client experiences pain at the insertion site
  d. When the tube becomes disconnected from the drainage system

[jessicaduplan]

Answer to Question 1

ANS: C
Clients with severe COPD may not be able to perform daily activities, including bathing and eating, because of excessive shortness of breath. The nurse should ask the client if shortness of breath is interfering with basic activities. Although the nurse should know about the client's support systems, current knowledge, and medications, these questions do not address the client's appearance.

Answer to Question 2

ANS: D
Intrathoracic pressures are less than atmospheric pressures; therefore, if the chest tube becomes disconnected from the drainage system, air can be sucked into the pleural space and cause a pneumothorax. A red, warm, and painful insertion site does not increase the client's risk for a pneumothorax. Tube drainage should decrease and become serous as the client heals. Sanguineous drainage is a sign of bleeding but does not increase the client's risk for a pneumothorax.