A patient with acute shortness of breath is admitted to the hospital. Which action should the nurse take during the initial assessment of the patient?
a.
... [Show More] Ask the patient to lie down to complete a full physical assessment.
b. Briefly ask specific questions about this episode of respiratory distress.
c. Complete the admission database to check for allergies before treatment.
d. Delay the physical assessment to first complete pulmonary function tests. - -b. Briefly ask specific questions about this episode of respiratory distress.
-The nurse prepares a patient with a *left-sided pleural effusion* for a *thoracentesis*. How should the nurse position the patient?
a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table - -d. Sitting upright with the arms supported on an over bed table
The upright position with the arms supported increases lung expansion, allows fluid to collect at the lung bases, and expands the intercostal space so that access to the pleural space is easier. The other positions would increase the work of breathing for the patient and make it more difficult for the health care provider performing the thoracentesis.
-A diabetic patient's arterial blood gas (ABG) results are *pH 7.28*; PaCO2 34 mm Hg; PaO2 85 mm Hg; *HCO3- 18* mEq/L. The nurse would expect which finding?
a. Intercostal retractions
c. Low oxygen saturation (SpO2)
b. Kussmaul respirations
d. Decreased venous O2 pressure - -b. Kussmaul respirations
Kussmaul (deep and rapid) respirations are a compensatory mechanism for metabolic acidosis.
The *low pH and low bicarbonate* result indicate *metabolic acidosis*.
Intercostal retractions, a low oxygen saturation rate, and a decrease in venous O2 pressure would not be caused by acidosis. [Show Less]