Which of the following is NOT a nursing intervention for asthma?

NHM UP Staff Nurse-2023 shift 1st

Medical & Surgical Nursing

Medium

Appeared in: NHM UP Staff Nurse-2023 shift 1st

Explanation

Elevating the foot of the bed is contraindicated for a patient in respiratory distress.
This position, known as the Trendelenburg position, causes abdominal organs to press against the diaphragm.
This pressure restricts diaphragmatic movement and lung expansion, making it harder for the patient to breathe.
The correct position to ease breathing is an upright or high Fowler's position, which allows for maximum chest and lung expansion.

Option B: Assessment of chest retractions is a critical nursing intervention for asthma. Retractions indicate the use of accessory muscles and signify increased work of breathing and severe respiratory distress.
Option C: Assessing breath sounds is a fundamental nursing intervention. It allows the nurse to detect wheezing, assess air movement in the lungs, and evaluate the effectiveness of bronchodilator treatments.
Option D: Arterial Blood Gas (ABG) monitoring is an important intervention, particularly in severe asthma attacks. It provides crucial information about the patient's oxygenation, ventilation (CO₂ removal), and acid-base status.

Clinical Relevance

Nursing practice connection: Knowing Nursing interventions and patient positioning for asthma helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Proper positioning is a simple, non-invasive, yet powerful nursing intervention to improve oxygenation and reduce the work of breathing in patients with asthma.
Failure to position the patient correctly can worsen their condition and lead to respiratory fatigue and failure.
What if the patient is hypotensive? While Trendelenburg is sometimes used for hypotension, in a patient with asthma, it is still contraindicated. The hypotension should be addressed with fluid resuscitation or vasopressors while maintaining a position that supports respiration, such as semi-Fowler's.

How to Approach the Question

First, identify the keywords in the question: 'NOT' and 'nursing intervention for asthma'. The word 'NOT' is critical; you are looking for the incorrect action or contraindication.
Evaluate each option based on your knowledge of respiratory physiology and asthma care.
Think about the pathophysiology of asthma: bronchoconstriction and difficulty breathing. Any intervention should aim to open the airways and ease the work of breathing.
Analyze Option A: 'Elevating the foot end of the bed'. Consider how this position (Trendelenburg) affects the diaphragm and lungs. It pushes abdominal contents up, restricting lung expansion. This would make breathing harder, not easier.
Analyze Options B, C, and D. These are all assessment techniques. Ask yourself: 'Would a nurse assess for retractions, listen to breath sounds, or check blood gases in an asthma patient?' Yes, these are all standard and essential parts of monitoring respiratory status.
Conclude that elevating the foot of the bed is the action that a nurse should NOT perform, making it the correct answer to this negatively-framed question.

Concept Tested & Keywords

Concept Tested: Nursing interventions and patient positioning for asthma.
Stem keywords: asthma, nursing intervention
Lead-in keywords: NOT
Negative lead-in flag: The question asks for an action that is NOT a correct nursing intervention.

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