Your patient with newly diagnosed COPD is receiving a beta 2 agonist via SVN for the first time. Preassessment shows HR 75 bpm with post assessment HR elevated to 132 bpm. The RT should:

Correct Answer: C

Rationale: The correct answer is C) Terminate the treatment and notify the physician. In this scenario, the significant increase in heart rate from 75 to 132 bpm post-administration of the beta-2 agonist via SVN indicates a severe adverse reaction to the medication, namely tachycardia. Tachycardia can be a dangerous side effect that can lead to further complications in a patient with COPD. Therefore, stopping the treatment and promptly notifying the physician is crucial to ensure the patient's safety and well-being. Option A is incorrect because continuing with the same medication via a different route (MDI/spacer) may still lead to the same adverse reaction due to the nature of the medication itself. Option B is incorrect as simply documenting the findings without taking immediate action to address the tachycardia is negligent and puts the patient at risk. Option D is incorrect because switching to a different medication without addressing the tachycardia first could exacerbate the situation and is not the immediate priority. This scenario provides valuable educational context for healthcare providers to recognize and respond to adverse drug reactions promptly and appropriately. Understanding the potential side effects of medications and knowing when to intervene or seek further guidance from a physician is essential in providing safe and effective patient care in a clinical setting.

Correct Answer: A

Rationale: In pediatric patients with croup, the correct clinical manifestation is inspiratory stridor (Option A). Inspiratory stridor is a high-pitched, musical sound heard during inspiration that indicates upper airway narrowing, which is characteristic of croup. This sound is caused by turbulent airflow through the narrowed airway structures, such as the larynx and trachea. Expiratory wheezing (Option B) is typically associated with lower airway conditions such as asthma or bronchiolitis, not croup. Bradypnea (Option C), which is abnormally slow breathing, is not a typical clinical manifestation of croup. Pleuritic chest pain (Option D) is more commonly seen in conditions affecting the pleura, such as pneumonia or pleurisy, rather than in croup. Educationally, understanding the specific clinical manifestations of croup is crucial for nurses caring for pediatric patients. Recognizing inspiratory stridor as a hallmark sign of croup can aid in prompt identification and appropriate intervention. This knowledge is essential for providing safe and effective care to pediatric patients with respiratory distress. Nurses must be able to differentiate between various respiratory conditions to ensure timely and accurate treatment, highlighting the importance of understanding the nuances of clinical presentations in pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) changes in the alveolar-capillary membrane and diffusion. When a patient with pneumonia exhibits below-normal oxygen saturation, it indicates impaired gas exchange in the lungs. Pneumonia causes inflammation and fluid buildup in the alveoli, affecting the alveolar-capillary membrane's ability to facilitate the diffusion of oxygen into the bloodstream. This disruption in the gas exchange process leads to decreased oxygen saturation levels in the blood. Option B) alterations in the structures of the ribs and diaphragm is incorrect because while conditions affecting these structures can impact respiratory mechanics, they do not directly cause decreased oxygen saturation in pneumonia. Option C) rapid decreases in atmospheric and intrapulmonic pressures is incorrect as well. While changes in pressure can influence gas exchange, pneumonia primarily affects the alveoli and their ability to exchange gases, rather than pressure differentials. Option D) lower-than-normal concentrations of environmental oxygen is incorrect since the patient's oxygen saturation is affected by the gas exchange within the lungs, rather than the external oxygen concentration. Educationally, understanding the pathophysiology of pneumonia-related oxygenation issues is crucial for nurses caring for patients with respiratory conditions. By recognizing the impact of pneumonia on the alveolar-capillary membrane and gas exchange, nurses can intervene promptly to improve oxygenation and prevent respiratory compromise in patients with pneumonia. This knowledge helps nurses provide appropriate respiratory support, monitor oxygen saturation levels, and collaborate with the healthcare team to optimize patient outcomes.

Correct Answer: D

Rationale: In the context of nursing fundamentals and oxygenation, it is crucial for a nurse to understand the importance of pre-oxygenating a patient before suctioning to prevent hypoxemia, a condition characterized by low oxygen levels in the blood. The correct answer, option D, which is to take several deep breaths, is the most appropriate action to ensure adequate oxygenation before suctioning. Taking deep breaths helps to increase the oxygen levels in the lungs, thereby providing a buffer against potential oxygen desaturation during the suctioning procedure. By pre-oxygenating the patient, the nurse is helping to optimize oxygen reserves in the body and minimize the risk of hypoxemia. Options A, B, and C are incorrect for various reasons. Option A, asking the patient to sit in an upright position and cough, may help with airway clearance but does not specifically address pre-oxygenation. Option B, instructing the patient to breathe normally for at least 5 minutes, does not actively enhance oxygen levels in the same way deep breathing does. Option C, advising the patient to lie flat in bed and practice relaxation, is not conducive to effective pre-oxygenation before a potentially oxygen-depleting procedure like suctioning. Educationally, it is essential for nurses to grasp the rationale behind pre-oxygenation strategies to maintain patient safety and well-being during interventions that may compromise oxygen levels. By understanding and implementing appropriate pre-suctioning practices, nurses can minimize the risk of complications such as hypoxemia and ensure optimal patient outcomes.