A patient, age 68, has a long history of COPD and is admitted to ...

[sammy]

A patient, age 68, has a long history of COPD and is admitted to the hospital with cor pulmonale. He says his doctor said his heart was failing and asks whether he is having a heart attack. Which explanation by the nurse is most correct?
 
  a. You aren't having a heart attack, but your heart has been damaged by changes in your lungs caused by your respiratory disease.
  b. It could be a heart attack, and when the heart is damaged it causes respiratory damage, too.
  c. It isn't a heart attack, but your heart has gradually weakened over the years, causing respiratory disease.
  d. It is probably a heart attack, since cor pulmonale means that the heart isn't getting enough blood and becomes too weak to pump effectively.

Question 2

An elderly patient with many health problems wants to save money to have a facelift. Which of the following is the most tactful and helpful comment a nurse can make?
 
  A) Cosmetic surgery is fine at any age if a patient can afford it, and will do much more for the appearance than any cosmetic.
  B) Cosmetic surgery is a waste of money for the elderly, but good cosmetics can be healthful and make you look much better.
  C) Cosmetic surgery may be fine, but good cosmetics can be a less expensive and effective option.
  D) Cosmetic surgery is inadvisable, and elderly patients should concentrate on inner beauty.

[mohan]

Answer to Question 1

A
COPD can lead to cor pulmonale, an abnormal cardiac condition characterized by hypertrophy of the right ventricle of the heart as a result of hypertension of the pulmonary circulation. Cor pulmonale results in the presence of edema in the lower extremities as well as in the sacral and perineal area, distended neck veins, and enlargement of the liver with ascites.

Answer to Question 2

C
Feedback:
Some elderly patients might benefit from cosmetic surgery if they can afford it and are otherwise healthy, but this patient is in neither category. Nevertheless, appearance can make a great contribution to a patient's morale, and the use of good cosmeticsthose that will retain moisture, especiallywill also aid in keeping the skin in good condition.