Question

Epistaxis and how to decrease it? 29- Teaching clients how to use room humidifier after a laryngectomy? 30- Prevention of frequent asthma attacks, which action should the nurse take first? 31- What teaching should be recommended to client who has cystic fibrosis (CF)? 32- Management of clients with chest tubes and deep breathing exercises? 33- Assessment of chronic obstructive pulmonary disease (COPD)? 34- What action to implements for clients with difficulty breathing? 35- How to properly care for client with an increased blood urea nitrogen (BUN)/creatinine ratio? 36- How to obtain a sterile urine specimen from a client’s Foley catheter? 37- A nurse cares for a client who is having trouble voiding? 38- Management of bacterial urethritis in post-menopausal pts? 39- Assesses clients at greatest risk for bladder cancer? 40- How should the nurse respond to pt complaining of burning upon urinating? 41- Manifestations of clients with acute glomerulonephritis (GN) and how to recognize signs of positive response to the prescribed treatment? 42- How to managed recovering patients from a nephrectomy secondary to kidney trauma? 43- Assessing pre-renal acute kidney injury (AKI? 44- Initial action for chronic kidney disease (CKD) of clients who is refusing to take his medication and has missed two hemodialysis appointments? 45- Management of kidney transplant and priority assessment to be done by nurse assigned? 46- A client has a long history of hypertension medications would the nurse expect to be ordered to avoid chronic kidney disease (CKD)? 47- Assessing clients understanding of nephrotic syndrome and normal glomerular filtration and nutritional therapy for this condition? 48- What are some major concerns of acute kidney injury (AKI) clients?

Answer 1

28. Epistaxis refers to the bleeding from the nose,the classification of nosebleeds is as anterior and posterior depending upon the source of bleeding.

Management

• Anterior bleeding is managed by digital pressure,gentle chemical cauterization ,or nasal packing.
• Quickly assess the airway,breathing and circulation
• Ensure bedside suctioning,provide emesis basin and tissues.
• Obtain vital signs and spo2 level,breath sounds,and administer oxygen via mask if needed
• Assess the signs and symptoms of heamodynamic instability,mental status,pallor,diaphoresis,hypotension,tachycaria and tachypnea
• If bleeding is significant place the patient on cardiac monitor,start fluids,obtain blood for coagulation profile and complete blood count.
• Obtain previous history of nose bleeds
• If posterior packing is used monitor respiratory status
• Instruct the patient to avoid blowing the nose

29.After laryngectomy extra humidity is required because the nose and mouth filter ,warm and moisten the air we breath are bypassed.Use a nebulizer or a room size or cool mist humidifier at home.Germs will grow in a humidifier.So clean the unit to decrease the chance of respiratory infections,the following steps can be used

1. Empty and rinse
2. Fill the humidifier tube with equal parts of vinegar and water and turn it on for 1 hour.
3. Empty the humidifier and wash all parts with hot soap water.Rinse well
4. Fill the tube with clean water and turn on the humidifier for another one hour
5. Empty and air dry.Unit is now ready for use.

30. Prevention of frequent asthma attacks usually involves learning to recognize the triggers and taking steps to avoid them. Tracking the breathing pattern and make sure that daily using asthma medications are keeping symptoms under control.In case of a sudden asthma attack use quick relief inhalers.

31.Client teaching

• Preventing infection-keep you lungs clean of extra mucus,wash hands with alcohol based cleaner,keeps the hands away from face.
• Avoid crowds especially in winter
• Make sure to take pancreatic enzymes exactly as ordered to improve digestion
• Encourage to exercise daily
• Avoid smoking
• Make follow-up appointments as soon as possible after leaving the hospital

32.

• Assess the respiratory status
• Place the patient in fowler's position
• Follow strict aseptic techniques while performeng dressing
• Maintain the patancy of the tube,check for obstruction
• Clamping the tube during transfer
• Observe for the fluctuation of water level
• Observe for any change in drainage colour
• Encourage the patient to change position to promote drainage
• Encourage deep breathing and arm exercises
• Allow the position comfortable to the patient

33.

1. Lung function tests-Spirometry is the most common lung function test
2. Chest X ray-show emphysema
3. CT scan-Help to detect emphysema
4. Arterial blood gas analysis-
5. Laboratory tests-

34.

• Avoidance of triggers that cause breathing difficulty
• Avoid smoking
• Eating healthful meals and exercising regularly
• eating smaller meals
• Taking allergic medications and avoiding allergens
• taking prescribed medications for chronic conditions and avoiding triggers
• Eating smaller meals for acid reflux and COPD
• Removal of objects in the throat in case of chocking.
• Inhalers for asthma and other upper respiratory infections