Author Question: A client complains of difficulty breathing. What will the nurse most likely assess in this client? ... (Read 52 times)

moongchi

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A client complains of difficulty breathing. What will the nurse most likely assess in this client?
 
  1. Use of accessory muscles
  2. Increased respiratory depth
  3. Increased respiratory rate
  4. Decreased respiratory depth
  5. Decreased respiratory rate

Question 2

A client who was a victim of a house fire is coughing. The nurse realizes that the purpose of the cough is to
 
  1. improve oxygenation.
  2. remove irritants from the nasal passages.
  3. remove irritants from the trachea or bronchi.
  4. close the glottis.



Swizqar

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Answer to Question 1

Correct Answer: 1, 2, 3, 4
Rationale 1: Use of accessory muscles is an assessment finding associated with difficulty breathing.
Rationale 2: Increased respiratory depth is an assessment finding associated with difficulty breathing.
Rationale 3: Increased respiratory rate is an assessment finding associated with difficulty breathing.
Rationale 4: The depth of respirations can be deeper (tidal volume greater than 500 mL of air) or more shallow if partial obstruction is present in conditions such as asthma. Respiratory rate is generally increased.
Rationale 5: Respiratory rate is generally increased.

Answer to Question 2

Correct Answer: 3
Rationale 1: Coughing does not improve oxygenation.
Rationale 2: Sneezing removes irritants from the nasal passages.
Rationale 3: The trachea and bronchi are lined with mucosal epithelium. These cells produce a thin layer of mucus that traps pathogens and microscopic particulate matter. These foreign particles are then swept upward toward the larynx and throat by cilia. The cough reflex is triggered by irritants in the larynx, trachea, or bronchi.
Rationale 4: Swallowing closes the glottis.



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moongchi

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Both answers were spot on, thank you once again




 

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