Comprehensive Respiratory System Disorders Q 74 - Gyan Darpan : Learning Portal
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Thursday, 21 April 2022

Comprehensive Respiratory System Disorders Q 74

The most reliable index to determine the respiratory status of a client is to:
     A. Observe the chest rising and falling.
     B. Observe the skin and mucous membrane color.
     C. Listen and feel the air movement.
     D. Determine the presence of a femoral pulse.

Correct Answer: C. Listen and feel the air movement.

To check for breathing, the nurse places her ear and cheek next to the client’s mouth and nose to listen and feel for air movement. During the inspection, the examiner should pay attention to the pattern of breathing: thoracic breathing, thoracoabdominal breathing, coastal markings, and use of accessory breathing muscles. The use of accessory breathing muscles (i.e., scalenes, sternocleidomastoid muscle, intercostal muscles) could point to excessive breathing effort caused by pathologies.

Option A: The chest rising and falling is not conclusive of a patent airway. The position of the patient should also be noted, patients with extreme pulmonary dysfunction will often sit up-right, and in distress, they assume the tripod position (leaning forward, resting their hands on their knees).
Option B: Observing skin color is not an accurate assessment of respiratory status. The body habitus of the patient could provide information regarding chest compliance, especially in the case of severely obese patients where chest mobility and compliance are reduced due to added weight from adipose tissue.
Option D: Checking the femoral pulse is not an assessment of respiratory status. Palpation should focus on detecting abnormalities like masses or bony crepitus. During palpation the examiner can evaluate tactile fremitus: the examiner will place both of his hands on the patient’s back, medial to the shoulder blades, and ask the patient to say “ninety-nine.”

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