a. Tracheal shift with unilateral decreased chest expansion
b. Increased PaCO2 and decreased PO2
c. Crackles on affected side
d. Hyporesonance on affected side
150. What advice should be given to a client’s spouse who apologizes for his hoarse voice saying he has had the problem for almost a month and it just seems to get worse not better?
a. “Gargle with salt and warm water three to four times per day.”
b. “If blood-streaked sputum develops, go to a clinic right away.”
c. “Have it checked without delay.”
d. “Rest your voice and drink a lot of fluid.”
149. Correct answer: a.
As air or fluid collects in the pleural space, the trachea is forced out of the midline toward the unaffected side. Simultaneous expansion of the lung and chest on the affected side is inhibited causing a unilateral decrease. Hypoxia and hypercapnia occur with pneumothorax so PaCo2 is decreased with pneumothorax and O2 is increased. No air is entering affected area so no breath sounds are heard. Hyperresonance occurs on affected side.
150. Correct answer: c.
Progressive hoarseness of more than 2-weeks duration is a symptom of glottis laryngeal cancer. Therefore, the client should be advised to see a physician right away. Telling the client to gargle or suggesting rest, although soothing, does not address the basic concern.