A patient is presenting with chronic obstructive pulmonary disease. The patient has
a chronic productive cough with dyspnea on excretion. Arterial blood
... [Show More] gases show a
low oxygen level and high carbon dioxide level in the blood. On assessment, the
patient has cyanosis in the lips and edema in the abdomen and legs. Based on your
nursing knowledge and the patient's symptoms, you suspect the patient suffers
from what type of COPD?
A. Emphysema
B. Pneumonia
C. Chronic bronchitis
D. Pneumothorax - C. Chronic bronchitis
***The answer is C. The key words to let you know the patient is experiencing
chronic bronchitis are: cyanosis and edema in the abdomen and legs. Remember
chronic bronchitis is sometimes referred to as "blue bloaters".
A patient with emphysema may present with all of the following symptoms
EXCEPT?
A. Barrel chest
B. Hyperinflation of the lungs
C. Hypoventilation
D. Hypercapnia - C. Hypoventilation
***The answer is C. Patients with emphysema present with HYPERventilation.
The body will try to compensate for the low oxygen blood levels and will cause the
patient to hyperventilate. Remember emphysema patients are sometimes called
"pink puffers". They will have a barrel chest (due to the use of accessory musclesfor breathing), hyperinflation of the lungs (due to damage of the alveoli sacs and
creation of air sacs), and hypercapnia (high carbon dioxide levels).
The term" blue bloaters" is used to describe patients with?
A. Pulmonary hypertension
B. Left-sided heart failure
C. Chronic Bronchitis
D. Emphysema - C. Chronic Bronchitis
***The answer is C. "Blue bloaters" is used to describe patients with chronic
bronchitis, and the term "pink puffers" is used to describe patients with
emphysema.
A patient is newly diagnosed with COPD due to chronic bronchitis. You're
providing education to the patient about this disease process. Which statement by
the patient indicates they understood your teaching about this condition?
A. "If I stop smoking, it will cure my condition."
B. "Complications from this condition can lead to pulmonary hypertension and
right-sided heart failure."
C. "I'm at risk for low levels of red blood cells due to hypoxia and may require
blood transfusions during acute illnesses."
D. "My respiratory system is stimulated to breathe due to high carbon dioxide
levels rather than low oxygen levels. - B. Complications from this condition can
lead to pulmonary HTN and right sided HF
An alarm beeps notifying you that one of your patient's oxygen saturation is
reading 89%. You arrive to the patient's room, and see the patient comfortably
resting in bed watching television. The patient is already on 2 L of oxygen via
nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing
action would be:A. Continue to monitor the patient
B. Increase the patient's oxygen level to 3 L
C. Notify the doctor for further orders
D. Turn off the alarm settings - A. Continue to monitor the patient
You are providing teaching to a patient with chronic COPD on how to perform
diaphragmatic breathing. This technique helps do the following:
A. Increase the breathing rate to prevent hypoxemia
B. Decrease the use of the abdominal muscles
C. Encourages the use of accessory muscles to help with breathing
D. Strengthen the diaphragm - D. Strengthen the diaphragm
Diaphragmatic breathing helps strengthen the diaphragm because it has become
flatten due to the hyperinflation of the lungs. Due to the flattening of the
diaphragm, the body is unable to breathe with ease and must use the accessory
muscles to compensate. Therefore, diaphragmatic breathing helps DECREASE the
breathing rate to prevent hypoxemia, INCREASES the use of the abdominal
muscles RATHER than accessory muscles and strengthens the diaphragm.
A patient with severe COPD is having an episode of extreme shortness of breath
and requests their inhaler. Which type of inhaler ordered by the physician would
provide the FASTEST relief for the patient based on this particular situation?
A. Spiriva
B. Salmeterol
C. Symbicort
D. Albuterol - D. AlbuterolThe answer is D. The patient would best benefit from a SHORT-ACTING
bronchodilator to help with the shortness of breath. The only short-acting
bronchodilator listed is Albuterol. Spiriva is a long-acting bronchodilator.
Symbicort is a combination of long-acting bronchodilator and corticosteroid.
Salmeterol is a long-acting bronchodilator.
Which of the following statements are incorrect about discharge teaching that you
would provide to a patient with COPD? Select-all-that-apply:
A. "It is best to eat three large meals a day that are relatively low in calories."
B. "Avoid going outside during extremely hot or cold days."
C. "It is important to receive the Pneumovax vaccine annually."
D. "Smoking cessation can help improve your symptoms." - The answers are A and
C. The patient needs to eat high calorie and protein rich meals that are small but
frequent. The Pneumovax is definitely recommended for patients with COPD but is
given every 5 years (not annually). [Show Less]