CBQ n0. 1 List 4 common symptoms of pneumonia the nurse might note on a physical exam.
Answer: Tachypnea, fever with chills, productive cough,bronchial breath sounds. CBQ no. 2 State 4 nursing interventions for assisting the client to cough productively.Answer: Deep breathing, fluid intake increased to 3 liters/day, use humidity to loosen secretions, suction airway to stimulate coughing. CBQ no. 3 What symptoms of pneumonia might the nurse expect to see in an older client?Answer: Confusion, lethargy, anorexia, rapid respiratory rate. CBQ no. 4 What should the O2 flow rate be for the client with COPD?Answer: 1-2 liters per nasal cannula, too much O2 may eliminate the COPD client s stimulus to breathe, a COPD client has hypoxic drive to breathe. CBQ no. 4 How does the nurse prevent hypoxia during suctioning?Answer: Deliver 100% oxygen (hyperinflating) before and after each endotracheal suctioning. CBQ no. 5 During mechanical ventilation, what are three major nursing intervention?Answer: Monitor client s respiratory status and secure connections, establish a communication mechanism with the client, keep airway clear by coughing/suctioning. CBQ no. 6 When examining a client with emphysema, what physical findings is the nurse likely to see?Answer: Barrel chest, dry or productive cough, decreased breath sounds, dyspnea, crackles in lung fields. CBQ no. 7 What is the most common risk factor associated with lung cancer?Answeer: Smoking CBQ no. 8 Describe the pre-op nursing care for a client undergoing a laryngectomy.Answer: Involve family/client in manipulation of tracheostomy equipment before surgery, plan acceptable communication method, refer to speech pathologist, discuss rehabilitation program.
. Encourage use of incentive spirometry every 2 hours. Good handwashing technique. client must wear mask if leaving room. private room.e.CBQ no. Make sure bottle III or end of chamber is bubbling.. Check all connections every 4 hours. CBQ no. Long-term need for daily medication.Answer: Cough into tissues and dispose immediately into special bags. 10 What immediate action should the nurse take when a chest tube becomes disconnected from a bottle or a suction apparatus? What should the nurse do if a chest tube is accidentally removed from the client?Answer: Place end in container of sterile water. 11 What instructions should be given to a client following radiation therapy?Answer: Do NOT wash off lines. 12 What precautions are required for clients with TB when placed on respiratory isolation?Answer: Mask for anyone entering room. Measure chest tube drainage by marking level on outside of drainage unit. CBQ no. 13 List 4 components of teaching for the client with tuberculosis. i.Answer: Maintain a dry occlusive dressing to chest tube site at all times. avoid use of powders/creams on radiation site. 9 List 5 nursing interventions after chest tube insertion. CBQ no. blood in secretions. Report symptoms of deterioration. wear soft cotton garments. CBQ no. Apply an occlusive dressing and notify physician STAT.