Author Question: The nurse is caring for a patient with advanced COPD who reports feeling short of breath. The nurse ... (Read 41 times)

tichca · **on:** Jul 23, 2018

The nurse is caring for a patient with advanced COPD who reports feeling short of breath. The nurse notes that the patient's lung sounds are diminished bilaterally and the patient's pulse oximetry is 91 on 2 L/min oxygen via nasal cannula.

What actions will the nurse take to make the patient more comfortable? (Select all that apply.)
a.
Increase the patient's oxygen to 4 L/min via nasal cannula.
b.
Suction the patient's airway using sterile technique.
c.
Maintain eye contact and provide calm reassurance.
d.
Turn the patient onto the side for postural drainage.
e.
Administer the ordered nebulized bronchodilator.
f.
Elevate the head of the patient's bed to fully upright.

Question 2

The nurse is performing a respiratory assessment on a patient. Which assessment findings indicate to the nurse that the patient has a history of long-standing chronic respiratory disease? (Select all that apply.)

a. All of the patient's fingernails are noticeably clubbed.
b. The patient needs to sleep on at least four to five pillows at night.
c. The patient's chest has equal antero-posterior and transverse diameters.
d. The patient's lower legs have large areas of brownish spotted discoloration.
e. The patient reports puffiness of both feet when standing for long periods.
f.
The patient's forced vital capacity test result is 3.8 L of air.

Melissahxx · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C, E, F
Patients who are acutely short of breath due to advanced COPD will benefit from nebulized bronchodilator medication to open the airways. Elevating the head of the bed will prevent pressure on the diaphragm from the abdominal contents. A caring demeanor with eye contact will help the patient remain calm until the medication begins to work and the shortness of breath is eased. Patients with COPD should be kept on low-flow oxygen to maintain pulse oximetry as close to 90 as possible.

Answer to Question 2

ANS: A, B, C
Clubbing of fingernails, the need to sleep in an upright position, and a barrel chest are all indicative of long-standing chronic respiratory disease like COPD. Brownish spotted discoloration is indicative of venous insufficiency. Forced vital capacity of almost 4 L is found in patients with good respiratory function.