Circumoral cyanosis may be present in extreme cases of respiratory distress. The nurse would expect the client to have a decreased forced expiratory volume because asthma is an obstructive pulmonary disease. Breath sounds will be "tight" sounding or markedly decreased; they won't be normal.6/42.A client with acute asthma is experiencing inspiratory and expiratory wheezes and a decreased forced expiratory volume. What is the priority intervention by the nurse?A. Beta-adrenergic blockersB. BronchodilatorsC. Inhaled steroidsD. Oral steroidsB: Bronchodilators are the first line of treatment for asthma because bronchoconstriction is the cause of reduced airflow. Beta-adrenergic blockers aren't used to treat asthma and can cause bronchoconstriction. Inhaled or oral steroids may be given to reduce the inflammation but aren't used for emergency relief.7/43. A client tells the nurse that he was recently diagnosed with an allergy to Chinese food after he experienced an asthmatic attack. The nurse determines that teaching is successful when the client makes which statement?A. "I should only eat Chinese food once per month."B. "I should use my inhalers before eating Chinese food."C. "I should avoid Chinese food because this is a trigger for me."D. "I should determine other causes because Chinese food wouldn't cause such a violent reaction.”C: If the trigger of an acute asthma attack is known, this trigger should be avoided at all times. Using an inhaler before eating wouldn't prevent the attack, and food is commonly a trigger for an acute asthma attack.
8/44.A 58-year-old client with a 40-year history of smoking one or two packs of cigarettes per day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this assessment, the nurse suspects the client maybe experiencing:A. acute respiratory distress syndrome (ARDS)B. asthmaC. chronic obstructive bronchitisD. emphysemaC: Because of his extensive smoking history and symptoms, the client most likely has chronic obstructive bronchitis. Clients with ARDS have acute symptomsof hypoxia and typically need large amounts of oxygen. Clients with asthma and emphysema tend not to have a chronic cough or peripheral edema.9/45.The nurse hears a physician refer to a client as a "blue bloater." The nurse is aware that this term refers to:A. acute respiratory distress syndrome (ARDS)B. asthmaC. chronic obstructive bronchitisD. emphysemaC: Clients with chronic obstructive bronchitis appear bloated; they have large barrel chests and peripheral edema, cyanotic nail beds, and, at times, circumoral cyanosis. Clients with ARDS are acutely short of breath and frequently need intubation for mechanical ventilation and large amounts of oxygen. Clients with asthma don't exhibit characteristics of chronic disease, and clients with emphysemaappear pink and cachetic.