A client with COPD develops a barrel chest over time. What is the primary reason for this change?

A. Normal cardiac output with impaired filling ability of the heart – This describes diastolic dysfunction, which can be part of heart failure, but not all heart failure involves normal cardiac output.
B. Normal cardiac output with impaired electrical conduction of the heart –This describes cardiac arrhythmias or conduction disorders, not heart failure.
C. Decreased cardiac output due to impaired pumping ability of the heart – Heart failure is a condition in which the heart is unable to pump enough blood to meet the body’s needs, resulting in reduced cardiac output. This can be due to systolic dysfunction (weakened contraction) or diastolic dysfunction (impaired filling).
D. Increased cardiac output due to excessive pumping ability of the heart – Heart failure is associated with decreased, not increased, cardiac output.

A. Alterations in touch – Metronidazole is not commonly associated with tactile (touch) changes. Neuropathy can occur with prolonged use, but this is not a typical early or sensory-specific effect.
B. Metallic taste – A metallic taste is a well-known and common adverse effect of metronidazole. Clients should be informed that this is unpleasant but not harmful.
C. Olfactory changes – Metronidazole does not typically cause changes in the sense of smell.
D. Hearing loss – Hearing loss is associated with other medications such as aminoglycosides, not metronidazole.