A nurse auscultates a client's lung fields. Which ...

[kwoodring]

A nurse auscultates a client's lung fields. Which pathophysiologic process should the nurse associate with this breath sound? (Click the media button to hear the audio clip.)
 
  a. Inflammation of the pleura
  b. Constriction of the bronchioles
  c. Upper airway obstruction
  d. Pulmonary vascular edema

Question 2

The nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur?
 
  1. Take as deep a breath as possible.
  2. Stand up (unless you have a physical disability).
  3. Place the meter in your mouth, and close your lips around the mouthpiece.
  4. Make sure the device reads zero or is at base level.
  5. Blow out as hard and as fast as possible for 1 to 2 seconds.
  6. Write down the value obtained.
  7. Repeat the process two additional times, and record the highest number in your chart.
  a.
  4, 2, 1, 3, 5, 6, 7
  b.
  3, 4, 1, 2, 5, 7, 6
  c.
  2, 1, 3, 4, 5, 6, 7
  d.
  1, 3, 2, 5, 6, 7, 4

[AmberC1996]

Answer to Question 1

ANS: A
A pleural friction rub can be heard when the pleura is inflamed and rubbing against the lung wall. The other pathophysiologic processes would not cause a pleural friction rub. Constriction of the bronchioles may be heard as a wheeze, upper airway obstruction may be heard as stridor, and pulmonary vascular edema may be heard as crackles.

Answer to Question 2

ANS: A
The proper order for obtaining a peak expiratory flow rate is as follows. Make sure the device reads zero or is at base level. The client should stand up (unless he or she has a physical disability). The client should take as deep a breath as possible, place the meter in the mouth, and close the lips around the mouthpiece. The client should blow out as hard and as fast as possible for 1 to 2 seconds. The value obtained should be written down. The process should be repeated two more times, and the highest of the three numbers should be recorded in the client's chart.

[kwoodring]

TYSM

[covalentbond]

Excellent