A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

Answer and Explanation

The Correct Answer is A

A. Respiratory acidosis: COPD often results in impaired gas exchange and decreased removal of carbon dioxide, leading to its accumulation in the blood. This results in respiratory acidosis, characterized by elevated PaCO2 and a decreased pH.

B. Respiratory alkalosis: This condition is generally associated with hyperventilation, where excessive loss of carbon dioxide leads to a higher blood pH. It is less common in COPD, where hypoventilation is more typical.

C. Metabolic acidosis: While COPD can sometimes lead to metabolic acidosis, it is not the primary condition associated with the disease. Metabolic acidosis usually results from conditions affecting the kidneys or metabolic processes.

D. Metabolic alkalosis: This is characterized by an increased blood pH due to a loss of acid or an excess of bicarbonate. It is not typically associated with COPD.

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Correct Answer is D

Explanation

A. Fever: Although fever can occur with various respiratory conditions, it is not the most specific early sign of an exacerbation in pulmonary sarcoidosis.

B. Weight loss: Weight loss is a more general symptom and not specifically indicative of an exacerbation of sarcoidosis.

C. Fatigue: Fatigue is a common symptom of sarcoidosis but is not necessarily an early sign of an exacerbation.

D. Shortness of breath: Shortness of breath is a significant early indicator of exacerbation in pulmonary sarcoidosis. It reflects worsening inflammation and granuloma formation affecting lung function.

A. Provide mouth care. B. Cup hands and tap on the client's chest repeatedly. C. Auscultate lung fields. D. Position the client so that the lung area to be drained is above the client's trachea.

Correct Answer is D

Explanation

A. Provide mouth care: Mouth care is important for overall comfort and hygiene but is not the first step in preparing for chest percussion, vibration, and postural drainage. The priority is to prepare the client for the procedures that will aid in clearing lung secretions.

B. Cup hands and tap on the client's chest repeatedly: This action is part of chest percussion and should be performed after positioning the client correctly. Percussion should be done on the appropriate lung areas based on the positioning.

C. Auscultate lung fields: Auscultation of lung fields is essential for assessing lung sounds and determining the effectiveness of therapy. However, it should be done after positioning the client to ensure that the correct areas are being treated and assessed.

D. Position the client so that the lung area to be drained is above the client's trachea: Proper positioning is crucial for effective postural drainage, as it allows gravity to assist in moving secretions from the lung areas to the central airways. This should be done before performing chest percussion or vibration.

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A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?

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