Question

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NSG 115 Case Study Week 14 Karena is Mr. Ross's nurse. She enters his room and auscultates his lung fields following his nebulizer treatment with albuterol delivered by respiratory therapy. Nicole knows that this medication will help Mr. Ross by increasing the diameter of the bronchi in his lung fields. 1. How will the albuterol help Mr. Ross? Select all that apply. A. It will open his bronchi, and his wheezing will resolve. B. By dilating his bronchi, it will improve his oxygenation. C. It will decrease inflammation and improve respiratory function. D. It will decrease the thickness of secretions, which will improve airway clearance. E It will provide protection against communicable disease. In assessing Mr. Ross's respiratory status, Karena observes his respiratory rate at 26 breaths per minute, labored, and his pulse oximetry reading of 90% on 2 L of O, per nasal cannula. She hears his complaint of dyspnea. His phlegm is green and thick and has an odor to it. She auscultates extremely diminished breath sounds in his right lower lung field, but his lungs have no wheezing post nebulizer treatment with albuterol just completed. His temperature is retaken axillary and is now 99.7" F. She notes the increase in temperature, the color and odor of the thick phlegm, and wants to provide the best care of her patient to help liquefy his respiratory secretions and ease the shortness of breath he complains of. 2. Which interventions will promote liquefying the respiratory secretions and easing shortness of breath? A. Having the patient eat five servings of fruit and vegetables a daily while sitting in a chair B. Having the patient use his incentive spirometer once an hour and administering a flu shot C. Having the patient drink 2 L of water daily and elevating the head of the bed 90 degrees D. Running a room dehumidifier and keeping the head of the bed at a low Fowler position 3. What interventions are best initiated to promote airway clearance for Mr. Ross? A. Use of a chest tube to reinflate the right lower lobe of the lungs B. Use of a BiPap while he is at rest maintain an open airway C. Use of a continuous positive airway pressure (CPAP) device while he is asleep to maintain an open airway D. Use of deep breathing, coughing, and incentive spirometry to aid airway clearance

Answer 1

No 1. Albuterol (Salbutamol) nebulization is a bronchodilator that increases the diameter of bronchos. Bronchodilator relaxes the smooth muscles of air passages to dilate them which decreases wheezing sound and improve oxygenation, some drug also reduces inflammation.

The main aim is to improve oxygenation so, the answer is by dilating his bronchi, it will improve oxygenation.

2. The increased temperature, diminished breath sound in the right lower lung, decrease saturation and green thick phlegm indicates Pneumonia. It may be due to seasonal influenza infection (Flu).

The spirometer can be a great aid to initiate airway clearance So, the answer is Having the patient use an incentive spirometer once an hour and administer a flu shot.

3. The best-initiated airway clearance for Mr ross is Deep breathing, coughing, and incentive spirometry in aid airway clearance.