A nurse is auscultating the lungs of a client who has pleurisy. Which of the following adventitious breath sounds should the nurse expect to hear?
Popping sounds
Loud, gating sounds
Snoring sounds
Squeaky, musical sounds
The Correct Answer is B
Rationale:
A. Popping sounds, also known as crackles, are typically associated with fluid in the alveoli, often seen in conditions like pneumonia or heart failure, not pleurisy.
B. Loud, grating sounds, known as pleural friction rub, are characteristic of pleurisy. This sound is produced by the inflamed pleural surfaces rubbing together during respiration.
C. Snoring sounds, or rhonchi, are usually heard in conditions involving airway obstruction by mucus, such as bronchitis, rather than pleurisy.
D. Squeaky, musical sounds, or wheezing, are associated with airway narrowing, such as in asthma or chronic obstructive pulmonary disease (COPD), and are not typically heard in pleurisy.
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Correct Answer is ["A","B","C","D","E","F"]
Explanation
Rationale:
A: Inhale deeply and then exhale completely: This step helps to empty the lungs, making room for the medication to be inhaled effectively.
B: Place her lips firmly around the mouthpiece: Ensuring a tight seal around the mouthpiece prevents the medication from escaping and ensures proper delivery to the lungs.
C: Breathe in deeply over 2 to 3 seconds while pushing down on the canister: Coordinating the inhalation with the activation of the canister ensures that the medication is inhaled deeply into the lungs.
D: Hold her breath for 10 seconds: Holding the breath allows the medication to settle in the lungs and increase its effectiveness.
E: Exhale slowly through pursed lips: This helps to maintain the medication in the lungs for as long as possible and promotes better absorption.
F: Wait 60 seconds between each puff: Waiting between puffs allows time for the medication to take effect and ensures that the next dose will be more effective.
Correct Answer is C
Explanation
Rationale:
A. Increasing carbohydrate intake is not recommended for clients with Cushing's disease as they are already at risk for hyperglycemia and weight gain due to the effects of excess cortisol.
B. Decreasing protein intake is not advisable because clients with Cushing's disease often suffer from muscle wasting and weakness. Adequate protein is necessary to help maintain muscle mass.
C. Clients with Cushing's disease should increase their intake of calcium and vitamin D because they are at risk for osteoporosis due to the effects of chronic corticosteroid exposure, which can lead to decreased bone density.
D. Clients with Cushing's disease often experience hypokalemia (low potassium levels), so limiting potassium-rich foods would not be beneficial. Instead, they should ensure adequate potassium intake.