d. Whether or not dyspnea interferes with ADLs e. Inspection of the external nose and
its symmetry f. Whether stridor is present with dyspnea - ✔️✔️
The nurse assessing the respiratory status of a client discovers that tactile fremitus has
increased from the assessment performed yesterday. For which possible respiratory
problem should the nurse assess further?
a. Pneumothorax
b. Pneumonia
c. Pleural effusion
d. Emphysema - ✔️✔️
CASE STUDY 1:
A 55-year-old woman with a long history of COPD and 40 years of smoking cigarettes is
being admitted to the pulmonary stepdown unit from the ED. The ED nurse reports that
the patient is on oxygen at 2 L per nasal cannula after having bronchodilator respiratory
treatment in the ED. She has bilateral expiratory wheezes and crackles both anteriorly
and posteriorly. A saline lock was placed in her right forearm for intermittent
medications.
Based on the patient's diagnosis, which clinical manifestations would the nurse expect
to see when assessing this patient? (Select all that apply.)
A. Bradycardia
B. Shortness of breath
C. Use of accessory muscles
D. Sitting in a forward posture E. Barrel chest appearance - ✔️✔️
CASE STUDY 1:
When the patient arrives to the unit, she is assessed and is in acute respiratory distress.
Her respirations are labored and her respiratory rate is 34. She states that she is
severely short of breath. Her oxygen saturation is 82% on O2 at 2 L via nasal cannula.
Based on these findings, what should the nurse do next? - ✔️✔️
CASE STUDY 1:
While the Rapid Response Team is at the bedside, the patient's healthcare provider
arrives. The provider writes several orders. Which order is most important for the nurse
to implement immediately?
A. Transfer to ICU
B. Increase O2 to 3 L per nasal cannula
C. ABGs 30 minutes after oxygen is increased
D. Methylprednisolone sodium succinate (Solu-Medrol) 40 mg IVP - ✔️✔️
3
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