The nurse assists the client with emphysema admitted because of a ...

[JGIBBSON]

The nurse assists the client with emphysema admitted because of a respiratory infection to assume what position to reduce the effort of breathing and improve gas exchange?
 
  1. Left Sims' position
  2. Fowler's position
  3. High Fowler's position
  4. Orthopneic position

Question 2

The nurse assesses respirations on a postoperative client receiving morphine every four hours, and anticipates which of the following?
 
  1. Morphine could cause a decrease in respirations.
  2. The client could be in pain and have increased respirations.
  3. The client might have increased respirations due to anxiety.
  4. The client will have normal respirations.

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Answer to Question 1

4
Rationale: This client, also with increased work of breathing, should be placed in the orthopneic position because it allows for the greatest chest expansion and makes breathing easier. The client is placed at a 90-degree angle leaning on an over-bed table to achieve this position. The second best position would be the high Fowler's or Fowler's position, but it is not as effective as the orthopneic position, because the pressure on the back reduces chest expansion. Sims' position is side-lying, and would likely increase the client's respiratory distress, as chest expansion would be reduced on the side she is lying on.

Answer to Question 2

1
Rationale: Morphine is a narcotic, and affects the respiratory center of the brain, resulting in decreased respirations. The effects of the morphine are likely to overcome any increase in respirations caused by pain, and morphine usually reduces client anxiety. It would not be abnormal to find a normal respiratory rate, but the anticipation would be for a slower rate.

[JGIBBSON]

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