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NurseDive Free Nursing Practice Question
A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?
A. The spacer increases the amount of medication delivered to the oropharynx.
The spacer increases the amount of medication delivered to the oropharynx.Spacers are designed to minimize the amount of medication deposited in the oropharynx (back of the throat) and reduce the risk of side effects such as oral thrush or hoarseness. The main purpose of using a spacer is to optimize the delivery of medication to the lungs.
B. The spacer increases the amount of medication delivered to the lungs.
The spacer increases the amount of medication delivered to the lungs.When reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma, the nurse should include the information that the spacer increases the amount of medication delivered to the lungs. Spacers help improve the delivery of medication from the MDI to the lungs by reducing the need for coordination between actuation of the MDI and inhalation. They also slow down the speed of the aerosolized medication particles, allowing more time for them to be inhaled into the lungs effectively.
C. Inhale rapidly when using the spacer with the MDI.
Inhale rapidly when using the spacer with the MDI. Inhaling rapidly may lead to improper inhalation technique and reduce the effectiveness of medication delivery to the lungs. Instead, the child should be instructed to inhale slowly and deeply to ensure that the medication reaches the lower airways.
D. Cover exhalation slots of the spacer with lips when inhaling.
Cover exhalation slots of the spacer with lips when inhaling.Covering the exhalation slots of the spacer with lips during inhalation is not recommended. These slots are designed to allow the child to exhale freely and prevent buildup of pressure within the spacer. Encouraging the child to exhale into the spacer would hinder proper inhalation technique and could lead to decreased medication delivery to the lungs.
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Full Explanation
A. The spacer increases the amount of medication delivered to the oropharynx.
Spacers are designed to minimize the amount of medication deposited in the oropharynx (back of the throat) and reduce the risk of side effects such as oral thrush or hoarseness. The main purpose of using a spacer is to optimize the delivery of medication to the lungs.
B. The spacer increases the amount of medication delivered to the lungs.
When reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma, the nurse should include the information that the spacer increases the amount of medication delivered to the lungs. Spacers help improve the delivery of medication from the MDI to the lungs by reducing the need for coordination between actuation of the MDI and inhalation. They also slow down the speed of the aerosolized medication particles, allowing more time for them to be inhaled into the lungs effectively.
C. Inhale rapidly when using the spacer with the MDI.
Inhaling rapidly may lead to improper inhalation technique and reduce the effectiveness of medication delivery to the lungs. Instead, the child should be instructed to inhale slowly and deeply to ensure that the medication reaches the lower airways.
D. Cover exhalation slots of the spacer with lips when inhaling.
Covering the exhalation slots of the spacer with lips during inhalation is not recommended. These slots are designed to allow the child to exhale freely and prevent buildup of pressure within the spacer. Encouraging the child to exhale into the spacer would hinder proper inhalation technique and could lead to decreased medication delivery to the lungs.
Similar Questions
Which of the following is true regarding the physiology of an open pneumothorax?
A. Air moves in and out of a wound in the chest wall.
Air moves in and out of a wound in the chest wall.In an open pneumothorax, also known as a sucking chest wound, there is a communication between the pleural space and the external environment through a wound in the chest wall. This allows air to move freely in and out of the pleural cavity during respiration. As a result, there is a loss of negative pressure within the pleural space, impairing lung expansion and leading to respiratory compromise. This condition is considered a medical emergency and requires prompt intervention to prevent tension pneumothorax and respiratory failure.
B. Air cannot pass freely into the thoracic cavity through a chest wound.
Air cannot pass freely into the thoracic cavity through a chest wound.In an open pneumothorax, air can pass freely into the thoracic cavity through the chest wound. This communication between the external environment and the pleural space results in air movement in and out of the wound during respiration.
C. There are no audible sounds in an open pneumothorax.
There are no audible sounds in an open pneumothorax. In an open pneumothorax, there may be audible sounds, such as sucking or hissing sounds, particularly during inspiration. These sounds occur due to the movement of air in and out of the chest wound and can be indicative of the condition.
D. The air is trapped when it enters the cavity.
The air is trapped when it enters the cavity.In an open pneumothorax, the air is not trapped when it enters the pleural cavity. Instead, air moves freely in and out of the wound in the chest wall, leading to respiratory compromise and potential progression to tension pneumothorax if left untreated.
Full Explanation
A. Air moves in and out of a wound in the chest wall.
In an open pneumothorax, also known as a sucking chest wound, there is a communication between the pleural space and the external environment through a wound in the chest wall. This allows air to move freely in and out of the pleural cavity during respiration. As a result, there is a loss of negative pressure within the pleural space, impairing lung expansion and leading to respiratory compromise. This condition is considered a medical emergency and requires prompt intervention to prevent tension pneumothorax and respiratory failure.
B. Air cannot pass freely into the thoracic cavity through a chest wound.
In an open pneumothorax, air can pass freely into the thoracic cavity through the chest wound. This communication between the external environment and the pleural space results in air movement in and out of the wound during respiration.
C. There are no audible sounds in an open pneumothorax.
In an open pneumothorax, there may be audible sounds, such as sucking or hissing sounds, particularly during inspiration. These sounds occur due to the movement of air in and out of the chest wound and can be indicative of the condition.
D. The air is trapped when it enters the cavity.
In an open pneumothorax, the air is not trapped when it enters the pleural cavity. Instead, air moves freely in and out of the wound in the chest wall, leading to respiratory compromise and potential progression to tension pneumothorax if left untreated.
Which of the following could the nurse expect to observe in an older adult client who has a pneumothorax?
A. Lower oxygen saturations of 93% to 94%
Lower oxygen saturations of 93% to 94%In an older adult client with a pneumothorax, the nurse could expect to observe lower oxygen saturations of 93% to 94%. A pneumothorax involves the accumulation of air in the pleural space, which can compress the lung and impair gas exchange, leading to hypoxemia (low blood oxygen levels). Decreased oxygen saturations would be a common finding in this condition.
B. Higher oxygen saturations of 98% to 99%
Higher oxygen saturations of 98% to 99%Higher oxygen saturations would be less likely in a client with a pneumothorax due to impaired gas exchange resulting from lung compression. Oxygen saturations are more likely to be lower in this condition, as indicated in option A.
C. Lower energy expenditure
Lower energy expenditure While a pneumothorax may cause discomfort and dyspnea, which could potentially decrease energy expenditure due to reduced activity levels, it is not a direct physiological effect of the condition. Energy expenditure would depend on various factors, including the severity of symptoms and the individual's overall health status.
D. Increased lung capacity
Increased lung capacityA pneumothorax typically results in a decrease in lung capacity rather than an increase. The accumulation of air in the pleural space causes partial or complete collapse of the affected lung, reducing its ability to expand and decreasing overall lung capacity. Therefore, increased lung capacity would not be expected in a client with a pneumothorax.
Full Explanation
A. Lower oxygen saturations of 93% to 94%
In an older adult client with a pneumothorax, the nurse could expect to observe lower oxygen saturations of 93% to 94%. A pneumothorax involves the accumulation of air in the pleural space, which can compress the lung and impair gas exchange, leading to hypoxemia (low blood oxygen levels). Decreased oxygen saturations would be a common finding in this condition.
B. Higher oxygen saturations of 98% to 99%
Higher oxygen saturations would be less likely in a client with a pneumothorax due to impaired gas exchange resulting from lung compression. Oxygen saturations are more likely to be lower in this condition, as indicated in option A.
C. Lower energy expenditure
While a pneumothorax may cause discomfort and dyspnea, which could potentially decrease energy expenditure due to reduced activity levels, it is not a direct physiological effect of the condition. Energy expenditure would depend on various factors, including the severity of symptoms and the individual's overall health status.
D. Increased lung capacity
A pneumothorax typically results in a decrease in lung capacity rather than an increase. The accumulation of air in the pleural space causes partial or complete collapse of the affected lung, reducing its ability to expand and decreasing overall lung capacity. Therefore, increased lung capacity would not be expected in a client with a pneumothorax.
A nurse is collecting data on a client who has COPD. Which of the following findings should the nurse expect?
A. Spoon nails
Spoon nailsSpoon nails, also known as koilonychia, refer to a concave or spoon-shaped deformity of the nails. This finding is associated with conditions such as iron deficiency anemia or certain systemic diseases, but it is not specifically associated with COPD.
B. Peripheral edema
Peripheral edemaPeripheral edema, or swelling of the extremities, is not a typical finding in COPD. It may occur in conditions such as heart failure, liver disease, or kidney disease, but it is not directly related to COPD unless there are comorbid conditions contributing to fluid retention.
C. Pleural friction rub
Pleural friction rub Pleural friction rub refers to a creaking or grating sound heard on auscultation of the lungs, typically during inspiration and expiration. It occurs when the inflamed pleural surfaces rub against each other. While pleural effusion (accumulation of fluid in the pleural space) may occur as a complication of COPD, pleural friction rub is not a typical finding in uncomplicated COPD.
D. Barrel chest
Barrel chestBarrel chest is a common finding in clients with COPD. It refers to an increased anterior-posterior diameter of the chest, giving it a rounded appearance similar to that of a barrel. This occurs due to hyperinflation of the lungs, which is characteristic of COPD, particularly in advanced stages. The hyperinflation leads to chronic air trapping and increased residual volume in the lungs, causing the chest to become enlarged and rounded.
Full Explanation
A. Spoon nails
Spoon nails, also known as koilonychia, refer to a concave or spoon-shaped deformity of the nails. This finding is associated with conditions such as iron deficiency anemia or certain systemic diseases, but it is not specifically associated with COPD.
B. Peripheral edema
Peripheral edema, or swelling of the extremities, is not a typical finding in COPD. It may occur in conditions such as heart failure, liver disease, or kidney disease, but it is not directly related to COPD unless there are comorbid conditions contributing to fluid retention.
C. Pleural friction rub
Pleural friction rub refers to a creaking or grating sound heard on auscultation of the lungs, typically during inspiration and expiration. It occurs when the inflamed pleural surfaces rub against each other. While pleural effusion (accumulation of fluid in the pleural space) may occur as a complication of COPD, pleural friction rub is not a typical finding in uncomplicated COPD.
D. Barrel chest
Barrel chest is a common finding in clients with COPD. It refers to an increased anterior-posterior diameter of the chest, giving it a rounded appearance similar to that of a barrel. This occurs due to hyperinflation of the lungs, which is characteristic of COPD, particularly in advanced stages. The hyperinflation leads to chronic air trapping and increased residual volume in the lungs, causing the chest to become enlarged and rounded.