Ch 24: Management of Patients with Chronic Pulmonary Disease

A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is: "I can refer you to the American Lung Association." "Have you tried to quit smoking before?" "Many options are available for you." "Nicotine patches would be appropriate for you."

"Have you tried to quit smoking before?" Rationale: All the options are appropriate statements; however, the nurse needs to assess the client's statement further. Assessment data include information about previous attempts to quit smoking.

The pathophysiology of emphysema involves destruction of the walls of the alveoli leading to impaired oxygen diffusion. True False

True

COPD is generally a progressive disease characterized by three primary symptoms: chronic cough, sputum production, and ________________.

dyspnea

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptom does the nurse anticipate assessing for this patient? chest pain during respiration fever, chills, and diaphoresis sputum and a productive cough tachypnea and tachycardia

sputum and productive cough Rationale: Chronic bronchitis, a disease of the airways, is defined as the presence of cough and sputum production for at least 3 months in each of 2 consecutive years.

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%. 54 mmHg; 84% 60 mmHg; 90% 56 mmHg; 86% 58 mmHg; 88%

60 mmHg; 90% Rationale: The goal is a PaO2 of at least 60 mmHg and an SaO2 of 90%.

A physician orders a beta2 adrenergic-agonist agent (bronchodilator) that is short-acting and administered only by inhaler. What drug would the nurse know to administer to the client? Formoterol Ipratropium bromide Albuterol Isoproterenol

Albuterol Rationale: Short-acting beta2-adrenergic agonists include albuterol, levalbuterol, and pirbuterol. They are the medications of choice for relief of acute symptoms and prevention of exercise-induced asthma. They are used to relax smooth muscle.

Administering oxygen to patients with COPD will result in cardiopulmonary arrest by suppressing the drive to breath. True False

False Rationale:

Asthma is considered a distinct, separate disorder from COPD and is classified as an abnormal airway condition characterized primarily by reversible inflammation. True False

True

Bronchospasm, which occurs in many pulmonary disease, reduces the caliber of the small bronchi and may cause dyspnea, static secretions, and infection. True False

True

Smoking cessation is the single most cost-effective intervention to reduce the risk of developing COPD and to stop its progression. True False

True

The most potent and effective anti-inflammatory medications currently available to treat asthma are __________.

corticosteroids

Asthma causes airway __________, mucosal edema, and mucus production.

hyperresponsiveness

The classification of Stage II of COPD is defined as severe COPD at risk for COPD mild COPD moderate COPD very severe COPD

moderate COPD Rationale: Stage II is moderate COPD. Stage 0 is at risk for COPD. Stage I is mild COPD. Stage III is severe COPD. Stage IV is very severe COPD.

The overall goals of __________ care are to manage symptoms and improve the quality of life for patients and families with advanced COPD.

palliative