A nurse is preparing to care for a client with bronchiectasis. The nurse should recognize that this client is likely to experience respiratory difficulties related to what pathophysiologic process?

A. "I understand what you mean, you can never be sure if the blood is tainted." This response would be inappropriate as it may increase the patient's anxiety and perpetuate fear about the transfusion. It does not provide accurate information about the safety of blood transfusions.

B. "I understand your concern. The blood is screened very carefully for different viruses as well as HIV." This response acknowledges the patient's concern while providing accurate and reassuring information. Blood donations are rigorously screened for HIV and other infectious diseases to ensure safety.

C. "If you don't have the blood transfusions, you may not make it through this episode of bleeding." While this statement is true, it focuses on the negative consequence without addressing the patient's fear. It also lacks a supportive and informative approach to the patient's concern about HIV.

D. "No one has gotten HIV from blood in a long time. You have to have the transfusion." This is dismissive and does not adequately address the patient's concern or provide accurate information about the safety measures in place for blood transfusions. It also pressures the patient into a decision without educating them.

A. Dilation of bronchi and bronchioles: Bronchiectasis is characterized by the permanent dilation and damage to the bronchi and bronchioles. This leads to a decrease in the ability of the airways to clear mucus effectively, resulting in chronic inflammation, recurrent infections, and respiratory difficulties.

B. Intermittent episodes of acute bronchospasm: While bronchospasm can occur in some respiratory conditions like asthma, it is not the primary process in bronchiectasis which involves persistent airway dilation rather than bronchospasm.

C. Alveolar distention and impaired diffusion: This describes emphysema, a condition often associated with COPD, where alveoli are damaged. It is not the main issue in bronchiectasis, which primarily affects the bronchi and bronchioles, not the alveoli.

D. Excessive gas exchange in the bronchioles: Bronchiectasis is characterized by impaired gas exchange due to airway damage, not excessive gas exchange, leading to inefficient oxygen exchange because of airway dilation, mucus accumulation, and chronic infections.