Question

a nurse is caring for a client who has status asthmaticus. which of the following are manifestations of this condition the nurse should recognize? (select all that apply.) extreme shortness of breath with difficulty speaking chest tightness and use of accessory muscles drowsiness with cyanosis closure of airway during inhalation initiate with respiratory acidosis

Explanation:

• Extreme shortness of breath with difficulty speaking: In status asthmaticus, severe airway constriction leads to significant airflow limitation. This makes it hard for the client to get enough air, resulting in extreme breathlessness. The effort of breathing also impairs speech as the client struggles to coordinate breathing and vocalization.
• Chest tightness and use of accessory muscles: Airway narrowing causes chest tightness. To compensate for the reduced airflow and try to get more air into the lungs, the body recruits accessory muscles (such as sternocleidomastoid, scalene muscles). These muscles help in expanding the thoracic cavity more forcefully during inhalation.
• Drowsiness with cyanosis: Severe and prolonged hypoxia (low oxygen levels) in status asthmaticus can affect the central nervous system, causing drowsiness. Cyanosis (bluish - discoloration of the skin and mucous membranes) occurs due to deoxygenated hemoglobin levels increasing as the body is unable to oxygenate the blood adequately.
• Closure of airway during inhalation: In status asthmaticus, the problem is mainly bronchoconstriction (narrowing of the airways due to smooth muscle contraction, mucus production etc.). The airways do not close completely during inhalation. Instead, there is significant narrowing that persists throughout the respiratory cycle.
• Inititate with respiratory acidosis: Status asthmaticus can lead to respiratory acidosis. But it is not an initiating factor. The primary issue is the airway obstruction (due to bronchoconstriction, inflammation, mucus plugging etc.) which over time (if not treated) can cause carbon dioxide retention (since the client cannot exhale effectively) leading to respiratory acidosis.

Answer:

Extreme shortness of breath with difficulty speaking, Chest tightness and use of accessory muscles, Drowsiness with cyanosis