A 55-year-old patient with increasing dyspnea is being evaluated ...

[Jipu 123]

A 55-year-old patient with increasing dyspnea is being evaluated for a possible diagnosis of chronic obstructive pulmonary disease (COPD).
 
  When teaching a patient about pulmonary function testing (PFT) for this condition, what is the most important question the nurse should ask?
  a. Are you claustrophobic?
  b. Are you allergic to shellfish?
  c. Do you have any metal implants or prostheses?
  d. Have you taken any bronchodilators in the past 6 hours?

Question 2

A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would be most appropriate?
 
  a. Have the patient rest in bed with the head elevated to 15 to 20 degrees.
  b. Ask the patient to rest in bed in a high-Fowler's position with the knees flexed.
  c. Encourage the patient to sit up at the bedside in a chair and lean slightly forward.
  d. Place the patient in the Trendelenburg position with several pillows behind the head.

[CourtneyCNorton]

Answer to Question 1

ANS: D
Pulmonary function testing will help establish the COPD diagnosis. Bronchodilators should be avoided at least 6 hours before the test. PFTs do not involve being placed in an enclosed area such as for magnetic resonance imaging (MRI). Contrast dye is not used for PFTs. The patient may still have PFTs done if metal implants or prostheses are present, as these are contraindications for an MRI.

Answer to Question 2

ANS: C
Patients with COPD improve the mechanics of breathing by sitting up in the tripod position. Resting in bed with the head elevated in a semi-Fowler's position would be an alternative position if the patient was confined to bed, but sitting in a chair allows better ventilation. The Trendelenburg position or sitting upright in bed with the knees flexed would decrease the patient's ability to ventilate well.

[Jipu 123]

Excellent

[bulacsom]

TYSM