How should the nurse position Mr. Jones’ chest drainage unit while he is transported?

Correct Answer: A

Rationale: The correct answer is A: Below the chest level. Positioning the chest drainage unit below the chest level allows for effective drainage of air or fluid from the chest cavity. Placing it above the chest level may cause backflow or air/fluid accumulation. Option B is incorrect as the unit should be secured to prevent dislodging during transport. Option C is incorrect as removing the unit can lead to complications. Option D is incorrect as clamping the tubes can result in a tension pneumothorax. Positioning the unit below the chest level ensures proper drainage and prevents complications during transport.

Correct Answer: C

Rationale: The correct answer is C: Increased anteroposterior chest diameter. In patients with chronic obstructive pulmonary disease (COPD), like Mr. Puff, there is often air trapping leading to hyperinflation of the lungs. This results in an increased anteroposterior chest diameter, known as a "barrel chest" appearance. Option A (‘Blue bloater’ appearance) is associated with chronic bronchitis, not necessarily COPD. Option B (Copious amount of thin sputum) is more indicative of bronchiectasis. Option D (Prolonged inspiratory time) is a nonspecific finding and not typically associated with COPD.

Correct Answer: D

Rationale: In the context of pharmacology and adult medical-surgical care, the correct answer, option D, stating the rationale for avoiding crowds when influenza or colds are prevalent, best reflects the achievement of avoiding infections for Mr. Puff. This is because individuals with compromised respiratory systems, such as Mr. Puff, are more susceptible to respiratory infections like influenza and colds, which can lead to serious complications. Avoiding crowded places reduces the risk of exposure to infectious agents, thereby helping to prevent infections. Option A, explaining the reason for avoiding aerosol sprays and powders, is not the best choice as it pertains more to respiratory irritants and allergens rather than infectious agents. Option B, explaining the reason for avoiding unnecessary physical activity, while important for general health and well-being, is not directly related to avoiding infections in Mr. Puff's case. Option C, listing causative organisms of bronchial infections, though relevant to understanding infections, does not directly address strategies for infection prevention. In an educational context, understanding the rationale behind infection prevention strategies is crucial for providing safe and effective care to patients, especially those with underlying health conditions. By selecting option D, students learn the importance of infection control measures tailored to specific patient needs, which is a fundamental aspect of pharmacological and medical-surgical nursing practice. This reinforces the significance of individualized care and patient education in preventing complications and promoting health outcomes.

Correct Answer: A

Rationale: Administering oxygen in treating COPD is crucial to relieve hypoxemia, which is a common complication of this condition. In COPD, there is impaired gas exchange in the lungs due to damaged airways and alveoli, leading to decreased oxygen levels in the blood. Supplemental oxygen helps to increase the oxygen concentration in the blood, improving oxygen delivery to tissues and organs, thereby alleviating symptoms like shortness of breath and preventing complications of hypoxemia, such as tissue damage and organ dysfunction. Option B is incorrect because administering oxygen does not increase carbon dioxide retention. In fact, it can help reduce carbon dioxide levels by improving oxygenation, which can indirectly decrease the respiratory drive as it is often driven by hypoxemia rather than hypercapnia. Option C is incorrect because administering oxygen does not increase the intensity of respiratory drive. In patients with COPD, the respiratory drive is often blunted due to chronic hypercapnia, so providing oxygen can actually help to normalize respiratory drive by correcting hypoxemia without increasing the drive to dangerous levels. Option D is incorrect because administering oxygen does not directly decrease respiratory secretions. Oxygen therapy is primarily aimed at improving oxygenation in COPD patients and does not have a direct effect on respiratory secretions. Educationally, understanding the rationale for administering oxygen in COPD is essential for nurses and healthcare professionals caring for patients with this condition. It underscores the importance of proper oxygen therapy to manage hypoxemia effectively and improve patient outcomes.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take if Wendy develops moderate hypotension and an irregular pulse while receiving aminophylline is option D: Slow the rate of aminophylline administration, monitor vital signs, and notify the physician. This option is the most appropriate because aminophylline is a bronchodilator that can cause side effects like hypotension and arrhythmias. By slowing the administration rate, the nurse can help decrease the likelihood of exacerbating these side effects while continuing to provide the therapeutic benefits of the medication. Option A is incorrect because simply monitoring vital signs without taking action to address the hypotension and irregular pulse is not sufficient when a patient is experiencing adverse effects from a medication. Option B is incorrect because abruptly discontinuing aminophylline can lead to rebound bronchoconstriction in patients who are receiving it for respiratory conditions. Option C is inappropriate because administering epinephrine in this situation could worsen the hypotension and irregular pulse, as epinephrine can further increase heart rate and blood pressure. In an educational context, it is crucial for nurses to understand the potential side effects of medications like aminophylline and how to appropriately respond to adverse reactions. By being knowledgeable about pharmacology principles and understanding the rationale behind each action, nurses can provide safe and effective care to their patients. This case highlights the importance of careful monitoring, appropriate interventions, and timely communication with the healthcare team when managing medication-related complications in clinical practice.