Photochemical reactor modeling: a case-study problem. Although radiation is important in heat transfer, an analogous model can be used in the design of photochemical reactors. The modeling of these reactors….
Assess the patency of the nasal sinuses.
You receive morning report for Ms. Malone, age 63, admitted to the hospital yesterday with fatigue, a cough, and dyspnea; she is diagnosed with chronic heart failure. She states that she had increasing difficulty with shortness of breath and swelling in her legs. Pedal pulses are +1 bilaterally. On auscultation you hear bilateral crackles in the lung bases and an S3 gallop when auscultating the heart. Respiratory rate is 18; heart rate is 84 and regular. The patient has an occasional nonproductive cough. She is receiving 2 L of oxygen by nasal cannula.
· During the assessment Ms. Malone reports that she had difficulty breathing during the night while lying flat. Which assessment approach should the nurse take first?
Ø Raise the head of the bed up to a 45-degree angle to auscultate the lungs.
Ø Auscultate for adventitious sounds in the lung bases.
Ø Assess the patency of the nasal sinuses.
Ø Palpate legs to determine whether there is increased edema from circulating blood volume.
· When examining Ms. Malone’s lower extremities, you note bilateral pedal edema of +2. Which statement by the patient shows that she correctly understands this finding?
Ø “I ate too many fruits and vegetables with vitamin C, and that causes me to retain water.”
Ø “I know that when my heart condition is not well controlled, my feet swell.”
Ø “My parents both had foot swelling as they aged, and that’s why my feet swell too.”
Ø “When my heart isn’t strong, the circulation doesn’t get down to my feet.”
· After receiving medications to manage her heart failure, you return to reassess Ms. Malone’s cardiac status. Select the techniques you use to correctly examine her lungs.
Ø Listen to an entire inspiration and expiration.
Ø Place the diaphragm of the stethoscope over the ribs.
Ø Begin auscultation at the apex, moving downward, auscultating the entire right lung and then the left.
Ø If you auscultate an abnormal breath sound, check for the presence of bronchophony.