A nurse is attending a social event when another guest coughs weakly once, grasps his throat with his hands, and cannot talk. Which of the following actions should the nurse take?
Perform the Heimlich maneuver.
Slap the client on the back several times.
Assist the client to the floor and begin mouth-to-mouth resuscitation.
Observe the client before taking further action.
The Correct Answer is A
Choice A reason:
The Heimlich maneuver, also known as abdominal thrusts, is the recommended first aid technique for a conscious person who is choking. This maneuver helps to expel the object blocking the airway by using the air remaining in the lungs to force it out. The nurse should stand behind the person, place their arms around the person’s waist, make a fist with one hand, and place it just above the navel. The other hand should grasp the fist, and quick, upward thrusts should be performed until the object is expelled.
Choice B reason:
Slapping the client on the back several times is not the recommended first action for a conscious adult who is choking. While back blows can be effective, they are typically used in combination with abdominal thrusts and are more commonly recommended for infants. For adults, the Heimlich maneuver is preferred as the initial response.
Choice C reason:
Assisting the client to the floor and beginning mouth-to-mouth resuscitation is not appropriate for a conscious person who is choking. Mouth-to-mouth resuscitation, or rescue breathing, is used when a person is not breathing and is unresponsive. In this scenario, the client is conscious but unable to speak, indicating a blocked airway that requires the Heimlich maneuver.
Choice D reason:
Observing the client before taking further action is not advisable in a choking emergency. Immediate intervention is crucial to prevent the situation from worsening. If the person is unable to speak, cough, or breathe, the Heimlich maneuver should be performed without delay.
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View Related questions
Correct Answer is C
Explanation
Choice A: I’ll Be Sure to Eat More Foods with Vitamin K
This statement indicates a misunderstanding. While vitamin K is essential for blood clotting, consuming large amounts of vitamin K can interfere with the effectiveness of warfarin. Patients on warfarin should maintain a consistent intake of vitamin K to avoid fluctuations in their INR levels.
Choice B: I’ll Take Aspirin for My Headaches
This statement also indicates a misunderstanding. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of bleeding when taken with warfarin. Patients should consult their healthcare provider before taking any new medications, including over-the-counter drugs.
Choice C: I’ll Use My Electric Razor for Shaving
This statement indicates an understanding of the teaching. Using an electric razor instead of a traditional blade can help prevent cuts and bleeding, which is particularly important for patients on anticoagulant therapy like warfarin.
Choice D: It’s Okay to Have a Couple of Glasses of Wine with Dinner Each Evening
This statement indicates a misunderstanding. Alcohol can affect the metabolism of warfarin and increase the risk of bleeding. Patients on warfarin should limit their alcohol intake and discuss their drinking habits with their healthcare provider to ensure safe use of the medication.
Correct Answer is B
Explanation
Choice A: Induce Sedation
Pancuronium is not used to induce sedation. It is a neuromuscular blocking agent (NMBA) that causes paralysis of skeletal muscles. Sedation is typically achieved using medications such as benzodiazepines or propofol, which act on the central nervous system to produce a calming effect.
Choice B: Suppress Respiratory Effort
Pancuronium is used to suppress respiratory effort in patients with ARDS who require mechanical ventilation. By causing muscle paralysis, pancuronium helps to synchronize the patient’s breathing with the ventilator, reducing the risk of ventilator-induced lung injury and improving oxygenation. This is particularly important in severe cases of ARDS where patient-ventilator dyssynchrony can be detrimental.
Choice C: Decrease Chest Wall Compliance
Decreasing chest wall compliance is not a purpose of pancuronium. In fact, pancuronium does not directly affect chest wall compliance. Instead, it works by blocking the transmission of nerve impulses to the muscles, leading to muscle relaxation and paralysis.
Choice D: Decrease Respiratory Secretions
Pancuronium does not decrease respiratory secretions. Medications such as anticholinergics (e.g., atropine) are used to reduce secretions. Pancuronium’s primary role is to facilitate mechanical ventilation by ensuring complete muscle relaxation.
