The nurse is performing an integumentary system assessment of a patient who has smoked for the last 40 years. The patient has clubbing of the fingernails. What does this finding indicate to the nurse?
The patient has asthma.
The patient has cardiovascular disease.
The patient has emphysema.
The patient has chronic hypoxemia.
The Correct Answer is D
A) The patient has asthma: While asthma can lead to respiratory symptoms and issues, it is not typically associated with clubbing of the fingernails. Asthma primarily affects airway constriction and inflammation, rather than causing the long-term changes in nail morphology seen with clubbing.
B) The patient has cardiovascular disease: Although some cardiovascular conditions can lead to clubbing, it is more commonly associated with chronic lung diseases. Cardiovascular disease might cause other signs or symptoms, but clubbing alone is not a definitive indicator of this condition.
C) The patient has emphysema: Emphysema, a type of chronic obstructive pulmonary disease (COPD), is characterized by the destruction of lung tissue and impaired airflow. While it can contribute to hypoxemia, clubbing is not a common finding specifically associated with emphysema.
D) The patient has chronic hypoxemia: Clubbing of the fingernails is a classic sign of chronic hypoxemia, often resulting from long-term respiratory conditions like COPD, interstitial lung disease, or lung cancer. It indicates a prolonged lack of oxygen in the blood, leading to changes in the nail bed and digit shape. Given the patient's long smoking history, chronic hypoxemia is the most likely explanation for this finding.
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Correct Answer is A
Explanation
A) No discomfort: When palpating the sinuses, the expected finding is that there should be no discomfort. Healthy sinuses typically do not cause pain or tenderness during palpation, indicating that they are clear and not inflamed or infected.
B) Lumps less than 1 centimeter: While lumps may be found in various areas of the body, the presence of lumps in the sinus area during palpation is not a typical finding and may indicate an abnormality or concern that would require further evaluation.
C) Painful sensation behind the eyes: A painful sensation behind the eyes can indicate sinusitis or other sinus issues. It is not an expected finding during a normal examination of the sinuses, as healthy sinuses should not cause discomfort.
D) Heavy pressure: Heavy pressure is often a symptom associated with sinusitis or sinus congestion, but it is not an expected finding during a routine palpation of the sinuses. Healthy sinuses should not feel heavy or pressured during examination.
Correct Answer is A
Explanation
A) "What can we do to accommodate your needs during your stay here?" This response is the most appropriate as it demonstrates cultural sensitivity and respect for the client’s religious practices. It opens the door for a collaborative discussion about how the healthcare team can support the client’s fasting while ensuring that his health needs are met during hospitalization.
B) "I will let your healthcare provider know that you need to be discharged." While it is important to communicate the client’s needs to the healthcare provider, suggesting discharge may not be a feasible solution. It does not address the complexities of fasting during hospitalization and could imply that the client’s faith is a burden rather than a respected aspect of their care.
C) "Fasting may be harmful to your body during your illness." While it is crucial to ensure the client’s health is not compromised, this response could come off as dismissive of the client’s beliefs. Instead of expressing concern, it could be more beneficial to explore how fasting can be managed within the context of their medical care.
D) "You must eat a high protein diet during times of illness." This response does not take into account the client’s religious beliefs and fails to respect the significance of fasting in the Muslim faith. While dietary considerations are important, this approach disregards the client’s right to practice their faith and may come across as prescriptive rather than collaborative.