A nurse is reinforcing discharge teaching with a client following an episode of status asthmaticus. The client has a prescription for two inhalations from an albuterol metered-dose inhaler. Which of the following statements by the client indicates an understanding of the teaching?
"I will hold the inhaler with my non-dominant hand."
"I will tilt my head forward while inhaling the medication."
"I will hold my breath at least 10 seconds after inhaling the medication."
"I will wait 10 min between each inhalation.
The Correct Answer is C
A. "I will hold the inhaler with my non-dominant hand.": The hand used to hold the inhaler is not as important as the technique for inhaling the medication.
B. "I will tilt my head forward while inhaling the medication.": The head should be in a neutral or slightly tilted back position to ensure proper inhalation of the medication.
C. "I will hold my breath at least 10 seconds after inhaling the medication." Holding the breath for at least 10 seconds allows the medication to be deposited more effectively in the airways, increasing its therapeutic effect.
D. "I will wait 10 min between each inhalation.": The correct time to wait between puffs is usually about 1-2 minutes, not 10 minutes.
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Correct Answer is A
Explanation
A. Continuous bubbling in the water-seal chamber: Continuous bubbling in the water-seal chamber indicates a possible air leak in the system, which needs to be assessed and potentially reported to the charge nurse for further evaluation.
B. Patient respiratory status is stable and denies pain to chest tube site: This is a normal finding and does not require reporting.
C. Tidalling, fluctuations in the fluid level in the water-seal chamber: This is a normal finding, indicating that the chest tube is functioning properly and that the lungs are expanding.
D. Occasional bubbling in the water-seal chamber: This may be acceptable, especially with respiratory movements, as it could indicate that the patient is exhaling, but continuous bubbling is concerning.
Correct Answer is A
Explanation
A. Encourage the client to cough and deep breathe. Encouraging the client to cough and deep breathe promotes the clearance of secretions and improves lung expansion, which is critical in treating pneumonia.
B. Encourage the client to increase oral fluids: This helps to thin secretions, but encouraging deep breathing and coughing is more immediate and effective for clearing secretions.
C. Provide chest percussion on the client: Chest percussion helps mobilize secretions but is not the priority before ensuring the client is actively coughing and deep breathing.
D. Obtain the client’s temperature: While monitoring vital signs is important, clearing secretions is the priority for improving respiratory status in pneumonia.