The nurse is caring for a client who experienced a flailed chest ...

[Mr3Hunna]

The nurse is caring for a client who experienced a flailed chest injury (multiple rib fractures) as a result of a motorcycle accident.
 
  The nurse realizes that pain management for this client will directly impact the effectiveness of his respiratory functioning primarily because:
  1. Pain increases metabolic needs, thus increasing oxygen consumption
  2. Pain increases emotional distress, which can lead to hyperventilation
  3. Pain will decrease the client's motivation to deep breathe, contributing to shallow, diminished inspirations
  4. Pain will decrease the client's ability to both relax and recuperate, thus extending the period of recovery

Question 2

The nurse suspects that a 59-year-old client has experienced angina pectoris. Which of the fol-lowing assessment questions will most likely produce information that will assist in the diagno-sis?
 
  1. How long did the pain last?
  2. Can you describe the pain for me?
  3. Did the pain radiate into your left arm?
  4. What were you doing when the pain started?

[spencer.martell]

Answer to Question 1

ANS: 3
Chest wall trauma and upper abdominal incisions decrease chest wall movement as the client uses shallow respirations to minimize chest wall movement to avoid pain.

Answer to Question 2

ANS: 1
Unlike the pain resulting from a myocardial infarction, anginal pain usually lasts from 1 to 15 minutes. The remaining questions could also relate to cardiac pain from other origins.