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 D
Explanation
A. Case manager: A case manager can help coordinate care but is not responsible for the specific education on BiPAP use.
B. Occupational therapist: Occupational therapists focus on daily living activities, not respiratory therapy.
C. Physical therapist: Physical therapists work on mobility and musculoskeletal issues, not respiratory support or BiPAP education.
D. Respiratory therapist: A respiratory therapist is responsible for providing education on the use of BiPAP, as they are specialists in respiratory equipment and therapy. They ensure that the client knows how to use the machine properly at home.