Mrs. Kerr has decreased air entry to the right lower lobe and oxygen saturation of 91%

QUESTION

Mrs. Kerr has decreased air entry to the right lower lobe and oxygen saturation of 91%. How should the practical nurse processes? a. Place client in high-Fowler’s position b. Perform intermittent oral and nasopharyngeal suctioning c. Teach client to perform deep breathing and coughing exercises. d. Apply oxygen at 4 L via nasal cannula and notify physician

ANSWER

When assessing a patient like Mrs. Kerr with decreased air entry to the right lower lobe and low oxygen saturation, a practical nurse should take the following steps:

1. Ensure Safety: First and foremost, ensure the safety of the patient by maintaining a calm and reassuring presence.

2. Assess Vital Signs: Check vital signs, including heart rate, respiratory rate, blood pressure, and oxygen saturation. In this case, oxygen saturation is already provided (91%), but monitor it continuously.

3. Positioning: Position Mrs. Kerr to optimize oxygenation. Placing her in a high-Fowler’s position (sitting upright with the head of the bed elevated) can improve lung expansion and oxygen exchange.

4. Oxygen Administration: Administer supplemental oxygen as prescribed by the physician. In this scenario, applying oxygen at 4 liters per minute via a nasal cannula is appropriate. Ensure proper placement and oxygen flow rate to maintain oxygen saturation within the desired range.

5. Monitor Respiratory Status: Continuously monitor Mrs. Kerr’s respiratory effort, including respiratory rate and the quality of breath sounds, especially in the right lower lobe. Report any changes or abnormalities promptly.

6. Suctioning: If indicated based on assessment findings, perform oral and nasopharyngeal suctioning to clear any secretions that may be obstructing the airway.

7. Breathing Exercises: Teach Mrs. Kerr deep breathing and coughing exercises to promote lung expansion, improve ventilation, and assist with secretion clearance. Encourage her to perform these exercises regularly.

8. Documentation: Thoroughly document all assessments, interventions, and the patient’s response to treatment. Include vital signs, oxygen saturation levels, lung sounds, and any changes in the patient’s condition.

9. Communication: Notify the physician or healthcare provider of the patient’s condition and interventions performed. Follow any prescribed orders or instructions provided by the physician.

10. Reassess and Monitor: Continuously reassess Mrs. Kerr’s respiratory status and response to interventions. Adjust the care plan as needed based on ongoing assessment findings.

It’s essential to provide Mrs. Kerr with appropriate care and support to address her decreased air entry and low oxygen saturation promptly. Timely intervention and effective communication with the healthcare team are critical in optimizing her respiratory status and overall well-being.