Evolve Copd Pneumonia

443 Words2 Pages
Which data should the PN collect next? Auscultate breath sounds The PN recognizes which finding supports Dan's diagnosis of pneumonia? Pulse rate of 115 Dan's ABGs are: pH- 7.28 pCO2- 55 HCO3- 25 pO2- 89 Based on these ABG results the PN recognizes the client is experiencing which acid-base imbalance? Respiratory acidosis When helping plan care for Dan, which nursing diagnosis has the highest priority? Ineffective airway clearance. Which is the most important intervention for the PN to implement for Dan's priority nursing diagnosis? Monitor rate and depth of respirations. Which outcome should the PN expect to note in Dan's plan care for the priority nursing diagnosis? Respiration rate will be 16 breaths per minute by the 4th hospital day. Methyl-prednisone 125 mg IVBP ordered. Dose on hand is 250 mg/mL. 0.5 mL Before administration of the first dose of Unasyn by the RN, which action should the PN implement? Obtain sputum specimen. While Dan is receiving Ventolin, which is the most important action for the PN to perform? Monitor pulse and BP What client instruction should the PN reinforce after observing Dan? Wait at least 1 min. Between each puff of the same medication. Which lab tests should the PN monitor for the client taking Azmacort? (Select all that apply) Potassium Blood Glucose Calcium For an acute episode of asthma, what additional instruction should the PN provide for Dan? (Select all that apply) Use the Ventolin inhaler for acute asthma attacks. Do not discontinue the drugs, unless directed by the ordering HCP. After checking the sensor site to make sure the oxygen saturation readings are accurate, which intervention should the PN initiate next? Elevate the head of the bed to a high-fowler's position. To ensure accurate oxygen saturation readings via pulse oximeter,

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