A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?

Correct Answer: B

Rationale: The correct answer is B) Practice inhaling through the nose and exhaling slowly through pursed lips. This technique, known as pursed lip breathing, helps to slow down breathing, improve oxygen exchange, and reduce shortness of breath in patients with emphysema. It prevents small airways from collapsing, making breathing more efficient. Option A is incorrect because allowing additional time for physical activities does not directly address dyspnea management in emphysema. It may help reduce oxygen demand but does not teach the client a specific technique to manage dyspnea. Option C is incorrect as using a humidifier may be beneficial for some respiratory conditions, but it is not the most effective strategy for managing dyspnea in emphysema. Emphysema is characterized by air trapping in the lungs, not necessarily related to air humidity. Option D is also incorrect because strengthening abdominal muscles through leg raises does not directly target dyspnea management in emphysema. While overall physical fitness is important, specific breathing techniques like pursed lip breathing are more effective for dyspnea control in emphysema. In an educational context, it's important for nurses to understand and teach evidence-based strategies for managing respiratory conditions like emphysema. Teaching patients effective breathing techniques empowers them to take control of their symptoms and improve their quality of life. Nurses play a crucial role in educating patients on self-management strategies to promote better health outcomes.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Pain when swallowing, which warrants immediate intervention by the nurse. The rationale for this choice is that pain when swallowing can indicate potential complications such as esophagitis or opportunistic infections like candidiasis, which are common in individuals with AIDS. These conditions can further compromise the client's respiratory status and lead to serious complications, making it crucial for the nurse to address this symptom promptly to prevent further deterioration in gas exchange. Option A) Elevated temperature is a common sign of infection, which is important to monitor but may not directly impact gas exchange as urgently as pain when swallowing in this context. Option B) Generalized weakness is a non-specific symptom that may be seen in various conditions and does not directly address the immediate respiratory concerns. Option C) Diminished lung sounds could indicate respiratory compromise, but given the client's specific condition of impaired gas exchange from a respiratory infection, the symptom of pain when swallowing takes precedence in terms of urgency for intervention. In an educational context, understanding the priority of symptoms and assessments in clients with complex conditions like AIDS is crucial for nurses caring for these individuals. Recognizing the significance of certain symptoms over others based on their potential impact on the client's health is a key aspect of providing effective and timely nursing care in such cases. By prioritizing interventions based on the client's specific needs and condition, nurses can optimize patient outcomes and ensure high-quality care delivery.

Correct Answer: D

Rationale: The most important finding for the nurse to report to the healthcare provider in this scenario is option D) Jaundiced sclera. Jaundice is a serious sign of liver dysfunction, which could be indicative of a potential infection such as hepatitis, especially considering the recent travel to a tropical climate where infectious diseases may be more prevalent. Liver involvement can lead to serious complications, especially in pediatric patients. Option A) Weakness and fatigue are non-specific symptoms that can be associated with various conditions and may not provide a clear indication of the underlying issue. Option B) Intestinal cramping, while uncomfortable for the client, is a common symptom of diarrhea and may not necessarily point to a more serious condition. Option C) Weight loss, while significant, may be a consequence of the diarrhea and not necessarily the most critical finding requiring immediate attention. In an educational context, understanding the significance of specific symptoms and their implications in pediatric patients is crucial for nurses caring for children with potential health concerns. Recognizing the priority signs and symptoms to report to healthcare providers can lead to timely interventions and improved outcomes for pediatric patients.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to take is Option A) Collect the blood sample. The reddened and engorged appearance of the distal tip of the finger after milking can be indicative of capillary refill, a sign that the circulation to the area is good. This means that the blood flow is adequate to obtain a reliable capillary blood sample for glucose testing. Option B) Assess radial pulse volume is incorrect because the appearance of the finger after milking does not necessarily correlate with the radial pulse volume. The focus here is on obtaining a blood sample for glucose testing, not on assessing pulse volume. Option C) Apply pressure to the site is incorrect as applying pressure can alter the blood flow to the area and potentially affect the accuracy of the glucose reading. Option D) Select another finger is also incorrect as the appearance of the finger is not a contraindication for collecting the blood sample. Educationally, this question highlights the importance of understanding the significance of capillary refill in relation to obtaining blood samples for testing. It reinforces the need for nurses to recognize normal physiological responses in pediatric clients and how these responses can impact nursing interventions. This knowledge is crucial in ensuring accurate assessments and appropriate care for pediatric patients.

Correct Answer: D

Rationale: In the context of a client with urolithiasis post-lithotripsy, the correct intervention to include in postoperative discharge instructions is option D) Give IV dose of adenosine rapidly over 1-2 seconds. Adenosine is commonly used to treat supraventricular tachycardia, a condition that can occur as a complication of lithotripsy due to the stress and pain associated with the procedure. Rapid administration of adenosine can help restore normal sinus rhythm by temporarily blocking conduction through the atrioventricular node. Option A) Prepare for transcutaneous pacing is incorrect as it is not indicated in this situation. Transcutaneous pacing is used for bradycardia or heart blocks, not for supraventricular tachycardia. Option B) Deliver another defibrillator shock is also incorrect. Defibrillation is used for life-threatening arrhythmias like ventricular fibrillation or ventricular tachycardia, not for supraventricular tachycardia. Option C) Administer IV Epinephrine per ACLS protocol is not the correct choice either. Epinephrine is typically used in cardiac arrest situations to improve myocardial and cerebral perfusion, not for treating supraventricular tachycardia post-lithotripsy. Educationally, understanding the appropriate pharmacological interventions post-lithotripsy is crucial for nurses caring for patients with urolithiasis. It is important to differentiate between different types of arrhythmias and their respective treatments to provide safe and effective care to patients recovering from procedures like lithotripsy.