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Chapter 21- Respiratory Function
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- 11. A nurse assesses an older adult's overall respiratory function. Which of the following interview questions would be most appropriate? A) "Would you be interested in finding out more about environmental smoke?" B) "Did either of your parents experience lung diseases?" C) "Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other pollutants?" D) "What do you do to actively maintain your respiratory health?"Ans: C
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The effects of air pollution are cumulative over many years. Thus, there is an increased impact on older adults over their lifetimes. Hazards in the workplace were unregulated before 1970. Therefore, there are older adults who have experienced cumulative and long-term effects from toxic substances. - 22. A 65-year-old client with a long-standing history of chronic obstructive pulmonary disease (COPD) was placed recently on Coumadin after experiencing atrial fibrillation. Upon discharge from the hospital, which of the following statements by the client indicates a need for further teaching? A) "I will continue to use smokeless tobacco since it's a lot better than smoking." B) "I will avoid using over-the-counter antihistamines since they can dry my mucosal secretions." C) "I will watch my intake of dark green leafy vegetables since they may impact the effects of Coumadin." D) "I will not take any herbal preparations without my health care provider's knowledge."Ans: A
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Smokeless tobacco is associated with mouth cancer, gingivitis, and tooth loss and may be carcinogenic to the pancreas. The other noted actions are appropriate to the maintenance of health. - 33. A 70-year-old client smoked for 30 years and has a history of COPD. The spouse assists with cooking, cleaning, and transportation. The spouse has become ill, and they now receive assistance from a home health nurse. Which of the following interventions should be the priority? A) Assisting the clients to perform instrumental activities of daily living (IADLs) B) Determining a plan for providing meals C) Setting up medications for the clients D) Smoking cessation planAns: B
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The nurse's role is not to perform the IADLs, but to plan for the IADLs including meals, cleaning, and transportation. There is no indication that the clients need their medications set up, smoking cession is important, but basic needs come first. - 44. A nurse completes assessment of an older adult. Which of the following physical assessment findings is within normal limits? A) Kyphosis and increased anteroposterior diameter of the chest B) Increased intensity of lung sounds C) Decreased resonance on percussion D) Decreased adventitious sounds in lower lungsAns: A
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Minor differences in assessment findings for healthy older adults include shortened thorax, chest wall stiffness, increased anteroposterior diameter of the chest, and forward-leaning posture because of kyphosis. - 55. A nurse plans interventions in a skilled nursing facility to prevent lower respiratory infections. Which of the following nursing interventions should be included in the plan? (Select all that apply.) A) Encourage annual pneumonia vaccinations. B) Encourage annual influenza vaccinations. C) Encourage annual chest radiographs to detect tuberculosis. D) Encourage influenza vaccinations every 5 years. E) Encourage hand hygiene for residents and staff.Ans: B, E
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Influenza vaccinations should be given yearly to older adults. The Centers for Disease Control and Prevention (CDC) recommends a one-time booster dose of the pneumonia vaccination for all people 65 years of age or older if they received an initial pneumonia vaccination 5 or more years earlier or were younger than 65 years of age when they first received the pneumonia vaccine. Chest radiographs will not prevent lower respiratory infections. Hand hygiene is essential in prevention of infections. - 66. A nurse in a long-term care facility is aware of the effects of age-related changes to the respiratory system. Which of the following functional consequences most likely results from age-related changes? A) Snoring and mouth breathing B) A persistent, dry cough C) Increased sensitivity to environmental allergens D) Hemoptysis on exertionAns: A
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Snoring and mouth breathing often become more prevalent with age. Hemoptysis and a persistent cough are considered pathologic at any age, and allergies do not typically worsen with age. - 77. A nurse admits an 81-year-old man to the hospital with aspiration pneumonia. Which of the following risk factors should the nurse predict that the client has in his history? A) Cigarette smoking B) Lung cancer C) Dysphagia D) Sleep apneaAns: C
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Dysphagia creates a serious risk for aspiration pneumonia. Smoking, cancer, and sleep apnea do not have a direct correlation with aspiration pneumonia. - 88. A 78-year-old client has been brought to the emergency department from home with a sudden change in mental status accompanied by significant weakness. For which condition should the health care providers assess? A) Alzheimer disease B) Lung cancer C) Pneumonia D) TuberculosisAns: C
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In older adults, pneumonia often has a presentation that differs from that of younger adults. Rather than presenting with a cough, chills, dyspnea, elevated temperature, and elevated white blood cell count, older adults are more likely to have subtler and nonspecific disease manifestations such as fatigue and change in mental status. Alzheimer disease has an insidious onset. Lung cancer and tuberculosis are not characterized by cognitive deficits. - 99. A community health nurse is to create initiatives to foster the health of older adults in the community. Which of the following health promotion activities has the greatest potential to promote the respiratory health of older adult participants? A) A lung cancer screening program B) A smoking cessation program C) A tuberculosis screening program D) A bronchitis immunization programAns: B
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As with younger adults, smoking cessation confers a multitude of health benefits, especially with regard to respiratory and cardiovascular health. Lung cancer screening and tuberculosis screening are less likely to benefit large numbers of participants. Bronchitis is not a health problem that is amenable to immunization. - 1010. A 72-year-old man's diagnostic testing and physical examination have resulted in a diagnosis of COPD. Which symptomatology is unexpected and will require follow-up? (Select all that apply.) A) Hemoptysis and orthostatic hypotension B) Chest pain and shortness of breath C) Cough and dyspnea D) Apneic spells and fatigue E) Wheezing and clubbingAns: C, D
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The most common manifestations of COPD are cough, dyspnea, wheezing, and increased sputum production. Hemoptysis and orthostatic hypotension are unexpected and require follow-up, as do apneic spells and fatigue. Chest pain and shortness of breath signal cardiac dysfunction and require immediate attention. - 1111. A nurse discusses common illnesses at the local health fair. The older adult asks, "Why do all my friends seem to get pneumonia? We never did when we were younger." Which of the following interventions should the nurse include in the teaching? A) Examinations by health care provider B) Hand hygiene C) Jogging/running D) Yearly pneumovaxAns: B
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Age-related alterations of the immune functions are a major contributing factor in the prevalence of lung diseases among older adults. Examinations are helpful in early identification of some lung diseases but not preventative regarding communicable diseases such as pneumonia. Pneumovax is not required yearly. - 1212. A nurse assesses older adults at a pulmonary clinic. Which of the following questions might best assist identify those at risk for pulmonary disorders? A) "Do any of your children smoke?" B) "In what state did you grow up?" C) "What type of job did you have?" D) "Where do you exercise?"Ans: C
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Some job categories are associated with an increased risk of respiratory disease. Children who smoke do not imply that secondhand smoke occurs. While location does correlate with the percent of smokers, it is not as helpful in identification of those with pulmonary disorders; nor is where a person exercises. - 1313. A nurse interviews an older adult with pulmonary disease. The client states, "I worked hard all my life in the shipyard, I provided for my family. I never smoked, why did I get this disease?" Which response by the nurse is best? A) "It is a good thing that you never smoked." B) "Pulmonary disease can happen to anyone." C) "The work in the shipyard put you at risk." D) "You feel like you are being punished…"Ans: C
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Shipyard work is a job category that is associated with an increased risk of respiratory disease. Caring responses give information and are directly related to the client's issue (and smoking is not). The client does not directly imply he feels punished. - 1414. A nurse plans care for a frail older adult in long-term care. Which of the following interventions should be included in the plan of care to reduce the risk of respiratory infections? A) Oral care B) Oxygen administration C) Pulmonary function testing D) Tracheal suctioningAns: A
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Poor oral care in long-term care residents increases the risk for pneumonia. Tracheal suctioning should be limited to those who are intubated. Neither testing nor oxygen would decrease risk of pneumonia. - 1515. A nurse admits an older adult from a long-term care facility into the hospital for respiratory infection. Which diagnostic testing should the nurse anticipate? A) Electrocardiogram B) Lung cancer screening C) Mantoux testing D) Pulmonary function testingAns: C
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Residents of long-term care are at risk for tuberculosis. While cancer and cardiac and lung function testing may occur, testing for tuberculosis should be done to screen for this contagious disease to protect others.
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- Nursing Fichas sobre Chapter 21- Respiratory Function, creado por Lesly Ramos el 27/04/2021.
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- Lesly Ramos
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