PrepU COPD

In which grade of COPD is the forced expiratory volume (FEV) less than 30%? I II III IV

Clients with grade III COPD demonstrate an FEV1 less than 30-50% predicted, with respiratory failure or clinical signs of right heart failure. Grade I is mild COPD, with an FEV1 ≥80% predicted. Clients with grade II COPD demonstrate an FEV1 of 50-80% predicted. Grade IV is characterized by FEV1 less 30% predicted.

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess? Lung sounds Skin color Heart rate Respiratory rate

A client with COPD is at risk for developing pneumothorax. The description given is consistent with possible pneumothorax. Though the nurse will assess all the data, auscultating the lung sounds will provide the nurse with the information if the client has a pneumothorax.

A young adult with cystic fibrosis is admitted to the hospital for an acute airway exacerbation. Aggressive treatment is indicated. What is the first action by the nurse? Collects sputum for culture and sensitivity Administers vancomycin intravenously Provides nebulized tobramycin (TOBI) Gives oral pancreatic enzymes with meals

Aggressive therapy for cystic fibrosis involves airway clearance and antibiotics, such as vancomycin and tobramycin, which will be prescribed based on sputum cultures. Sputum must be obtained prior to antibiotic therapy so results will not be skewed. Administering oral pancreatic enzymes with meals will be a lesser priority.

Which clinical finding would be most closely associated with a client who has interstitial lung disease in comparison to chronic obstructive pulmonary disease (COPD)? Audible wheezing on expiration Reduced expiratory flow rates Decreased tidal volume Normal forced expiratory volume

Because it takes less work to move air through the airways at an increased rate than it does to stretch a stiff lung to accommodate a larger tidal volume, interstitial lung disease is commonly associated with an increased respiratory rate but decreased tidal volume. Wheezing and decreased expiratory flow rate are more closely associated with COPD.

In which statements regarding medications taken by a client diagnosed with COPD do the the drug name and the drug category correctly match? Select all that apply. Albuterol is a bronchodilator. Dexamethasone is an antibiotic. Cotrimoxazole is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid.

Correct response: Albuterol is a bronchodilator. Ciprofloxacin is an antibiotic. Prednisone is a corticosteroid. Explanation: Theophylline, albuterol, and atropine are bronchodilators. Dexamethasone and prednisone are corticosteroids. Amoxicillin, ciprofloxacin, and cotrimoxazole are antibiotics. All of these drugs could be prescribed to a client with COPD.

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

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 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 mm Hg; 84% 56 mm Hg; 86% 58 mm Hg; 88% 60 mm Hg; 90%

The goal is a PaO2 of at least 60 mm Hg and an SaO2 of 90%.

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

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

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

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

Oxygen has been prescribed for a client with chronic obstructive pulmonary disease (COPD). Which amount of oxygen is considered most appropriate for the COPD client? 1 to 2 L/min 4 to 6 L/min 10 L/min 5 L/min

The goal of oxygen delivery for a client with COPD is to keep the PO2 at about 60 mm Hg or less, which can be accomplished with delivery of 1 to 2 L/min of oxygen (this will result in a PO2 at 55 to 65 mm Hg). All the other options would increase the PO2 above 60 mm Hg, which tends to depress the hypoxic stimulus for ventilation and often leads to hypoventilation and carbon dioxide retention

A nursing student asks if a client diagnosed with chronic obstructive pulmonary disease (COPD) is at risk if he receives oxygen at a level that increases the PO2 above 60 mm Hg. The best response would be: The client's ventilation will be severely depressed. The client will increase his respiratory drive. Keeping the client on oxygen to maintain the PO2 at above 60 mm Hg will cure the disease process. Administering oxygen at this level will assist with the removal of carbon dioxide.

Because the ventilatory drive associated with hypoxic stimulation of the peripheral chemoreceptors does not occur until the arterial PO2 has been reduced to about 60 mm Hg or less, increasing the arterial PO2 above 60 mm Hg tends to depress the hypoxic stimulus for ventilation and often leads to hypoventilation and carbon dioxide retention. A client with chronic respiratory disease receiving increased levels of PO2 would tend to depress the hypoxic stimulus for ventilation and lead to hypoventilation and carbon dioxide retention. It would not cure the disease process.

Which client is exhibiting signs of advanced chronic obstructive pulmonary disease (COPD)? The client who is: sitting in a chair, respirations shallow, 2+ pitting ankle edema present. reclining in semi-Fowler's position, talking on phone, taking breaths in mid-sentence. sitting in bed resting elbows on overbed table, expiratory wheezes noted. walking in hall with pursed lip breathing, pulse oximeter reads 90%.

COPD progresses from relatively mild manifestations in the early stages to severe respiratory impairment where breathing is labored, even at rest. In addition, the expiratory phase is prolonged, and expiratory wheezes and crackles can be auscultated. Use of accessory muscles such as the sternocleidomastoid, scalene, and intercostal muscles is common. The client will also use pursed-lip breathing to increase expiratory volume.

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient? Chest pain during respiration Sputum and a productive cough Fever, chills, and diaphoresis Tachypnea and tachycardia

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.

A client has undergone pulmonary diagnostic studies where the results show a mismatching of ventilation and perfusion. Which diagnosis is most likely associated with this finding? Pulmonary embolism Pulmonary hypertension Pleural effusion Chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) results in inflammation and fibrosis of the bronchial wall, hypertrophy of the submucosal glands and hypersecretion of mucus and loss of elastic lung fibers and alveolar tissue. Inflammation and fibrosis of the bronchial wall, along with excess mucus secretion and destruction of elastic fibers, cause mismatching of ventilation and perfusion. The other options do not apply to an occurring mismatching.

For a client with advanced chronic obstructive pulmonary disease (COPD), which nursing action best promotes adequate gas exchange? Encouraging the client to drink three glasses of fluid daily Keeping the client in semi-Fowler's position Using a Venturi mask to deliver oxygen as ordered Administering a sedative as ordered

The client with COPD retains carbon dioxide, which inhibits stimulation of breathing by the medullary center in the brain. As a result, low oxygen levels in the blood stimulate respiration, and administering unspecified, unmonitored amounts of oxygen may depress ventilation. To promote adequate gas exchange, the nurse should use a Venturi mask to deliver a specified, controlled amount of oxygen consistently and accurately. Drinking three glasses of fluid daily wouldn't affect gas exchange or be sufficient to liquefy secretions, which are common in COPD. Clients with COPD and respiratory distress should be placed in high Fowler's position and shouldn't receive sedatives or other drugs that may further depress the respiratory center.

Which statement is true about both lung transplant and bullectomy? Both procedures cure COPD. Both procedures treat end-stage emphysema. Both procedures treat patients with bullous emphysema. Both procedures improve the overall quality of life of a client with COPD.

Treatments for COPD are aimed more at treating the symptoms and preventing complications, thereby improving the overall quality of life of a client with COPD. In fact, there is no cure for COPD. Lung transplant is aimed at treating end-stage emphysema and bullectomy is used to treat clients with bullous emphysema.