Answer to Question 1
Correct Answer: 1, 2, 4
Pollution and cigarette smoke can further damage already traumatized lung tissue and should be avoided. Lifestyle modifications to conserve energy and reduce oxygen demands are necessary, as lung tissues are still recovering from the damage of the disease process. Exertional dyspnea will continue to increase if additional demands are made on the pulmonary and cardiovascular system. Immunizations for pneumonia and flu are encouraged to minimize additional insults to lung tissue, as the entire physical status of lung tissue will require up to 6 months to recover. Fluids are needed to rehydrate lung tissue and to enhance renal function by diluting wastes from tissue repair. CHF from right-sided failure is possible, but not usually in the recovery phase (after discharge from the hospital). These patients are not immunocompromised and can attend large-crowd events, such as church services, without risk.
Answer to Question 2
Correct Answer: 1
Corticosteroids are given after the bronchodilator, as the bronchodilator opens the airways. Corticosteroids require weeks to begin to have an effect on breathing and therefore cannot be used for acute attacks. Corticosteroids are usually not combined with methylxanthines but may be combined with adrenergic stimulants. The anticholinergics affect the muscarinic receptors.