Author Question: A nurse is teaching the staff about alterations in breathing patterns. Which information will the ... (Read 71 times)

panfilo · **on:** Jul 22, 2018

A nurse is teaching the staff about alterations in breathing patterns. Which information will the nurse include in the teaching session? (Select all that apply.)

a. Apneano respirations
b. Tachypnearegular, rapid respirations
c. Kussmaul'sabnormally deep, regular, fast respirations
d. Hyperventilationlab ored, increased in depth and rate respirations
e. Cheyne-Stokesabnormally slow and depressed ventilation respirations
f. Biot'sirregular with alternating periods of apnea and hyperventilation respirations

Question 2

When taking an adult blood pressure, the onset of the sound the nurse hears is at 138, the muffled sound the nurse hears is at 70, and the disappearance of the sound the nurse hears is at 62. How should the nurse record this finding?

a. 68
b. 76
c. 138/62
d. 138/70

jharrington11 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

ANS: A, B, C
ApneaRespirations cease for several seconds. Persistent cessation results in respiratory arrest. TachypneaRate of breathing is regular but abnormally rapid (greater than 20 breaths/min). Kussmaul'sRespirations are abnormally deep, regular, and increased in rate. HyperventilationRat e and depth of respirations increase; breaths are not labored. Hypocarbia sometimes occurs. Cheyne-StokesRespiratory rate and depth are irregular, characterized by alternating periods of apnea and hyperventilation. Biot'sRespirations are abnormally shallow for 2 to 3 breaths followed by irregular period of apnea.

Answer to Question 2

ANS: C
138/62 is the correct reading. The fifth sound marks the disappearance of sound. In adolescents and adults the fifth sound corresponds with the diastolic pressure. The fourth sound becomes muffled and low pitched as the cuff is further deflated. At this point the cuff pressure has fallen below the pressure within the vessel walls; this sound is the diastolic pressure in infants and children. 68 is the pulse pressure of 138/70; 76 is the pulse pressure for 138/62.