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 B
Explanation
A) Eupnea: Eupnea refers to a normal respiratory rate, typically between 12 to 20 breaths per minute for adults. Given that the client’s respiratory rate is significantly lower than this range, documenting the finding as eupnea would not accurately reflect the client’s condition.
B) Bradypnea: Bradypnea is defined as a slower-than-normal respiratory rate, usually less than 12 breaths per minute. With the client's rate at 9 breaths per minute, this is an example of bradypnea. It is crucial for the nurse to document this finding accurately, even though the client denies feeling short of breath, as it could indicate an underlying issue requiring further assessment.
C) Tachypnea: Tachypnea indicates a faster-than-normal respiratory rate, typically over 20 breaths per minute. Since the client's respiratory rate is low at 9 breaths per minute, labeling it as tachypnea would be incorrect and misleading.
D) Dyspnea: Dyspnea refers to difficulty or discomfort in breathing. Although the client does not report feeling short of breath, it is essential to note that the low respiratory rate could still lead to respiratory distress, but it does not meet the criteria for dyspnea based on the client's self-report. Therefore, documenting this finding as dyspnea would not be appropriate.
Correct Answer is A
Explanation
A) "Women should be familiar with their own breasts so that they can report any changes to their provider": This statement aligns with current recommendations emphasizing the importance of breast self-awareness. Women are encouraged to be familiar with their breast tissue so they can recognize any changes, such as lumps or alterations in size or shape, and report these changes to their healthcare provider. This proactive approach can lead to earlier detection of breast cancer.
B) "All women should have a breast screening with an MRI beginning at age 40": This statement is misleading, as the American Cancer Society does not recommend routine MRI screenings for all women. MRI is typically reserved for women at high risk for breast cancer. The standard guideline includes annual mammograms starting at age 40, but not MRI for all.
C) "Mammograms do not help with detecting breast cancer until after age 54": This statement is incorrect. Mammograms are effective in detecting breast cancer well before age 54, and the American Cancer Society recommends that women start getting annual mammograms at age 40. Early detection through regular screenings is critical for improving outcomes.
D) "Mammograms are only indicated if there is a strong family history": This statement is also inaccurate. While family history can increase the risk for breast cancer and may influence screening frequency, all women are encouraged to have regular mammograms starting at age 40, regardless of family history. This guideline aims to catch potential cancers early in all women.