Author Question: A patient has a long history of chronic obstructive pulmonary disease (COPD). During the assessment, ... (Read 50 times)

saliriagwu · **on:** Jun 25, 2018

A patient has a long history of chronic obstructive pulmonary disease (COPD). During the assessment, the nurse will most likely observe which of these?

a. Unequal chest expansion
b. Increased tactile fremitus
c. Atrophied neck and trapezius muscles
d. Anteroposterior-to-transverse diameter ratio of 1:1

Question 2

An adult patient with a history of allergies comes to the clinic complaining of wheezing and difficulty in breathing when working in his yard. The assessment findings include tachypnea, the use of accessory neck muscles, prolonged expiration, intercostal

retractions, decreased breath sounds, and expiratory wheezes. The nurse interprets that these assessment findings are consistent with:
a.
Asthma.
b.
Atelectasis.
c.
Lobar pneumonia.
d.
Heart failure.

adammoses97 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
An anteroposterior-to-transverse diameter ratio of 1:1 or barrel chest is observed in individuals with COPD because of hyperinflation of the lungs. The ribs are more horizontal, and the chest appears as if held in continuous inspiration. Neck muscles are hypertrophied from aiding in forced respiration. Chest expansion may be decreased but symmetric. Decreased tactile fremitus occurs from decreased transmission of vibrations.

Answer to Question 2

ANS: A
Asthma is allergic hypersensitivity to certain inhaled particles that produces inflammation and a reaction of bronchospasm, which increases airway resistance, especially during expiration. An increased respiratory rate, the use of accessory muscles, a retraction of the intercostal muscles, prolonged expiration, decreased breath sounds, and expiratory wheezing are all characteristics of asthma.