Chapter 22: Acute Bronchospasm Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient diagnosed with asthma has been prescribed three bronchodilator treatments but continues to experience wheezing and shortness of breath. The health care provider caring for the patient notes an oxygen saturation of 90% on room air. What action is indicated?

a. Administer oxygen and continue to monitor the patient.

b. Contact the respiratory therapist to administer another treatment.

c. Notify the patient’s physician immediately.

d. Reassure the patient that the treatments will take effect soon.

ANS: C a. Breathlessness with minimal activity or eating b. Pausing to breathe while attempting to talk c. Repetitive, spasmodic coughing at night d. Wheezing after exposure to a trigger

Patients with bronchospasm who have oxygen saturations less than 92% on room air and who fail to improve with nebulizer treatment given three times, need physician consultation. While oxygen administration and further nebulizer treatments may be indicated, it is incorrect to continue to monitor the patient without notifying the physician.

2. Which symptom in a patient diagnosed with asthma indicates severe bronchospasm?

ANS: B

Inability to speak a full sentence without pausing to breathe indicates severe bronchospasm. Breathlessness, repetitive and spasmodic coughing, and wheezing are all common signs of bronchospasm and do not necessarily indicate severe bronchospasm.

Multiple Response

NURSINGTB.COM a. A silent chest after previously wheezing b. Decreasing blood pressure c. Presence of an urticarial rash d. Pulsus paradoxus of 10 mm Hg e. Wheezing on both inspiration and expiration

1. Which clinical findings are worrisome in a patient experiencing acute bronchospasm, requiring immediate treatment? (Select all that apply.)

ANS: A, B, C

A silent chest indicates severe spasm and is an ominous sign. Decreasing blood pressure and urticarial rash are present with anaphylaxis, which is a respiratory emergency requiring oxygen, diphenhydramine or epinephrine. A pulsus paradoxus greater than 25 mm Hg is worrisome. Wheezing on inspiration and expiration is a common finding and not necessarily an emergency.