Following segmental resection for bronchiectasis, what is most important for Mr. Jones?

Correct Answer: A

Rationale: In the context of pharmacology and post-segmental resection for bronchiectasis, the most appropriate action for Mr. Jones is option A) Cough and deep breathe every 1-2 hours. This is crucial post-operatively to prevent complications such as atelectasis and pneumonia. Coughing helps clear secretions and maintains airway patency, while deep breathing aids in lung expansion and prevents respiratory complications. Option B) Limit fluid intake is incorrect as adequate hydration is important post-operatively to prevent dehydration and promote healing. Limiting fluid intake can lead to complications such as electrolyte imbalances. Option C) Lie flat in bed is incorrect as it can increase the risk of respiratory complications such as aspiration and decrease lung expansion. Proper positioning, including sitting upright or in semi-Fowler's position, promotes optimal lung function. Option D) Receive analgesia every 6 hours is incorrect as pain management is important post-operatively, but it is not the most crucial intervention in this scenario. Coughing and deep breathing take priority to prevent respiratory complications. In an educational context, understanding the rationale behind post-operative care following segmental resection for bronchiectasis is essential for nursing practice. Nurses need to prioritize interventions that promote respiratory function and prevent complications to ensure optimal patient outcomes. Ongoing assessment and patient education are also vital components of post-operative care in this context.

Correct Answer: A

Rationale: In the context of respiratory isolation, option A, using disposable tissues for respiratory secretions, is the correct choice for Mr. Dean's teaching plan. This practice helps prevent the spread of respiratory infections by containing potentially infectious secretions. It promotes proper infection control measures and protects both Mr. Dean and those around him. Option B, reporting allergies to the staff, is not directly related to respiratory isolation and does not address the specific precautions needed to prevent the spread of respiratory infections. Option C, asking family and friends not to visit, while a valid infection control measure in some situations, may not always be necessary or feasible. Option D, getting the patient out of bed frequently, is important for preventing complications like pressure ulcers but is not directly related to respiratory isolation practices. In an educational context, understanding the rationale behind each option helps students grasp the importance of specific infection control measures in preventing the spread of communicable diseases, especially in vulnerable populations like those in respiratory isolation. Teaching these principles equips future nurses with the knowledge and skills to provide safe and effective care for their patients.

Correct Answer: B

Rationale: In this scenario, the correct action that assumes the greatest priority for Mr. Walker is option B) Monitor respiratory status for increasing dyspnea. This is because Mr. Walker presents with a productive cough, dull percussion notes, and rhonchi, which are indicative of respiratory distress and potential respiratory infection. Monitoring his respiratory status will help in early detection of any worsening symptoms such as increased dyspnea, which could signal a deterioration in his condition and the need for prompt intervention. Option A) Determine if Mr. Smith has a history of COPD is incorrect as it does not address the immediate need for monitoring and assessing the current respiratory status of Mr. Walker. Option C) Discuss ways to prevent pneumonia is also incorrect as it is a preventive measure and does not address the immediate need for managing Mr. Walker's current respiratory symptoms and potential infection. Option D) Obtain a physician’s order for sedatives is not appropriate in this case as sedatives would not address the underlying respiratory issues causing Mr. Walker's symptoms and could potentially worsen his condition. In an educational context, it is crucial for nursing students to understand the prioritization of nursing actions based on the patient's presenting symptoms and needs. Monitoring respiratory status in a patient with respiratory distress is a critical nursing intervention to ensure timely and appropriate care for the patient. This question highlights the importance of quick and accurate assessment in managing patients with respiratory issues in a medical-surgical nursing setting.

Correct Answer: D

Rationale: The correct nursing action of sitting Mr. Puff up in bed with arms resting on pillows on the overbed table is the most appropriate in the given scenario. This position promotes optimal lung expansion, which can help improve his respiratory effort and oxygenation. By sitting him up, it reduces pressure on his diaphragm, allowing for better lung expansion and oxygen exchange, thus improving his cyanosis and shallow respirations. Option A is incorrect as changing his nasal cannula to a Venturi mask may not address the immediate need for improved oxygenation that sitting him up would provide. Option B of offering water to increase fluid intake is also inappropriate as it does not address the respiratory distress Mr. Puff is experiencing. Option C of walking him in the hall to increase mobility is contraindicated in this situation as his respiratory status needs to be stabilized first before considering ambulation. In an educational context, this scenario highlights the importance of understanding the physiological principles behind positioning for optimal respiratory function in patients experiencing respiratory distress. Nurses must prioritize interventions that address the immediate needs of the patient to ensure their safety and well-being.

Correct Answer: B

Rationale: In assessing Mr. Stout with chronic bronchitis, the presence of a chronic cough (Option B) would be the sign one would expect to find. This is because chronic bronchitis is characterized by inflammation of the bronchial tubes leading to excessive mucus production, resulting in a persistent cough that lasts for at least three months in two consecutive years. Option A, loss of weight, is less specific to chronic bronchitis and can be seen in a variety of health conditions. Option C, barrel chest, is more commonly associated with conditions like emphysema rather than chronic bronchitis. Option D, scanty sputum, is not typical of chronic bronchitis, as this condition is characterized by increased sputum production. In an educational context, understanding the specific signs and symptoms of chronic bronchitis is crucial for nurses to provide accurate assessments, care, and education to patients. By knowing that a chronic cough is a hallmark sign of chronic bronchitis, nurses can intervene appropriately by providing symptom management strategies, patient education on smoking cessation, and promoting respiratory health.