Chapter 24: Management of Patients with COPD

What is histamine, a mediator that supports the inflammatory process in asthma, secreted by?

Mast cells

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:

diminished or absent breath sounds on the affected side.

A nurse has just completed teaching with a client who has been prescribed a meter-dosed inhaler for the first time. Which statement if made by the client would indicate to the nurse that further teaching and follow-up care is necessary?

"I do not need to rinse my mouth with this type of inhaler."

In which statements regarding medications taken by a client diagnosed with COPD do the drug name and the drug category correctly match?

-Albuterol is a bronchodilator. -Ciprofloxacin is an antibiotic. -Prednisone is a corticosteroid.

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?

Albuterol

Which statement describes emphysema?

A disease of the airways characterized by destruction of the walls of overdistended alveoli

Which of the following is accurate regarding status asthmaticus?

A severe asthma episode that is refractory to initial therapy

Which is the strongest predisposing factor for asthma?

Allergy

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for:

Atelectasis

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction and that leads to the collapse of alveoli. What complication should the nurse monitor for?

Atelectasis

Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation?

Bronchitis

A patient is prescribed a mast cell stabilizer for the treatment of asthma. Which commonly used medication will the nurse educate the patient about?

Cromolyn sodium

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

A junior-level nursing class has just finished learning about the management of clients with chronic pulmonary diseases. They learned that a new definition of COPD leaves only one type of disorder within its classification. Which of the following is part of that disorder?

Emphysema

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?

High-protein

In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?

I

Asthma is cause by which type of response?

IgE-mediated

Which of the following is the key underlying feature of asthma?

Inflammation

The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?

Providing sufficient oxygen to improve oxygenation

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

Respiratory Acidosis

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

The classification of Stage III of COPD is defined as

Severe COPD

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education?

The patient should take the medication an hour before meals or 2 hours after a meal.

The classification of Stage II of COPD is defined as

moderate COPD