A client diagnosed with chronic obstructive lung disease who is ...

[dalyningkenk]

A client diagnosed with chronic obstructive lung disease who is receiving oxygen at 1.5 liters per minute via nasal cannula is complaining of shortness of breath. What action should the nurse take?
 
  1. Increase the oxygen to 3 liters per minute via nasal cannula.
  2. Lower the head of the client's bed to the semi-Fowler's position.
  3. Have the client breathe through pursed lips.
  4. Encourage the client to breathe more rapidly.

Question 2

After learning of a terminal illness and life expectancy, the client begins to hyperventilate and complains of being light-headed with the fingers, toes, and mouth tingling. What action should be taken by the nurse?
 
  1. Prepare to resuscitate the client.
  2. Have the client concentrate on slowing down respirations.
  3. Place the client in Trendelenburg's position and ask him to cough forcefully.
  4. Administer 25 mg of meperidine (Demerol) according to the prn pain order.

[wilsonbho]

Answer to Question 1

Correct Answer: 3
Rationale 1: In the client with chronic obstructive lung disease, the drive to breathe is often dependent upon low oxygen concentration. Increasing oxygen delivery by increasing the oxygen from 1.5 Lpm to 3 Lpm may be dangerous to this client.
Rationale 2: Lowering the head of the bed makes it more difficult to breathe. This client should have the head of the bed elevated to the Fowler's position or should be assisted to lean over the overbed table to increase chest excursion.
Rationale 3: The client should be taught to breathe out against pursed lips to increase the time it takes to exhale and to help keep airways open.
Rationale 4: Chronic obstructive lung disease makes it difficult for the client to breathe out, so increasing the rate of respiration will not be helpful.

Answer to Question 2

Correct Answer: 2
Rationale 1: There is no indication that this client needs resuscitation.
Rationale 2: This client is hyperventilating and should be assisted to slow down respirations. Techniques to slow respirations include counting respirations or having the client match respirations with the nurse, who then slows down the respiratory rate.
Rationale 3: There is no need to place the client in Trendelenburg's position for coughing.
Rationale 4: Demerol may slow breathing, but is not necessary at this time.

[dalyningkenk]

Excellent

[JaynaD87]

TYSM