The nurse is caring for a patient with bronchiectasis. Based on an understanding of the pathologic changes that occur with this disease, which intervention to promote clearance of respiratory secretions does the nurse plan?
a. Postural drainage
b. Intermittent positive pressure breathing
c. Pursed-lip breathing
d. Diaphragmatic breathing
A
Encourage postural drainage. Suction the patient as needed and provide assistance in turning, coughing, and deep breathing every 2 hours. Assist with chest physiotherapy.
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The middle ear is normally filled with:
a. air. b. blood. c. serous fluid. d. cerebrospinal fluid.
What cancer screening or prevention activity is most important to include when examining the client, a 20-year-old man who has Down syndrome?
A. Encouraging him to eat more fruit and leafy green vegetables B. Teaching him how to perform self testicular examination C. Assessing his skin for bruises and petechiae D. Testing his stool for occult blood
Mr. W, a hospice client, wishes to treat his anemia so he will not feel so fatigued. Which of the following would be least appropriate to suggest?
1. Iron-fortified cereals 2. Citrus fruits with every meal 3. Chicken breasts every other day 4. Raisins and prunes for snacks
The client is a single parent being seen at an employee wellness clinic. The client tells the nurse he has three school-age children who participate in various activities
He states, "Every night, I am taking them to soccer practice, football practice, Girl Scouts. I have to fix dinner and then go over homework. I have no time for myself. I am so tired." The client exhibits tremors of his hands. Blood pressure is 140/88 mm Hg, heart rate is 98 beats/minute, and respirations are 30 breaths/minute. Data best supports which of the following nursing diagnoses? A) Stress Overload related to single parenting B) Defensive Coping related to inability to appraise stressors C) Hopelessness related to multiple responsibilities D) Disturbed Sleep Pattern related to anxiety