Author Question: A client with chronic obstructive pulmonary disease (COPD) demonstrates a consistently low pulse ... (Read 32 times)

Caiter2013 · **on:** Jul 23, 2018

A client with chronic obstructive pulmonary disease (COPD) demonstrates a consistently low pulse oximetry value. The nurse notes a ruddy facial color with purple undertones and recognizes the effects of which elevated blood levels?

1. Colony-stimulating factors and white blood cells
2. Erythropoietin and red blood cells
3. Interleukin II and macrophage activity
4. Colony-stimulating factors and serum ferritin

Question 2

A client has a surgical wound infection. The nurse recognizes that a healthy body will respond by rapidly increasing colony-stimulating factors (CSFs) in the blood. How does this increase help in fighting the infection?

1. Slowed migration of leukocytes
2. Elevated level of serum antibodies
3. Increased phagocytosis
4. Decreased antibody toxicity

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

Answer to Question 1

Correct Answer: 2
Rationale 1: Colony-stimulating factors produce only increased white cells, which would not result in the assessment described.
Rationale 2: Erythropoietin is high due to chronically low levels of oxygen passing through the kidneys. The resultant increase in RBCs gives the COPD client the classic ruddy complexion.
Rationale 3: Interleukin II and macrophage levels are regulated by white blood cells. An increase in these factors would not result in the assessment described.
Rationale 4: Serum ferritin is needed to produce the high level of RBCs, but iron itself does not affect pulse oximetry or skin color.
Global Rationale: Erythropoietin is high due to chronically low levels of oxygen passing through the kidneys. The resultant increase in RBCs gives the COPD client the classic ruddy complexion. Colony-stimulating factors produce only increased white cells, which would not result in the assessment described. Interleukin II and macrophage levels are regulated by white blood cells. An increase in these factors would not result in the assessment described. Serum ferritin is needed to produce the high level of RBCs, but iron itself does not affect pulse oximetry or skin color.

Answer to Question 2

Correct Answer: 3
Rationale 1: Migration of leukocytes is generally enhanced when active infection is present.
Rationale 2: Colony-stimulating factors can elevate serum antibody levels. That reaction is not relevant in fighting an active wound infection.
Rationale 3: White cell phagocytosis is increased by CSFs and is necessary because of a heavy load of bacteria in the wound.
Rationale 4: Increased levels of CFS increase antibody toxicity.
Global Rationale: White cell phagocytosis is increased by CSFs and is necessary because of a heavy load of bacteria in the wound. Migration of leukocytes is generally enhanced when active infection is present. Colony-stimulating factors can elevate serum antibody levels. That reaction is not relevant in fighting an active wound infection. Increased levels of CFS increase antibody toxicity.