A nurse is reviewing the arterial blood gas (ABG) result for a client diagnosed with progressive chronic obstructive pulmonary disease (COPD). The nurse should expect which of the following ABG findings for a client diagnosed with progressive COPD?

pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L

pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L

pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L

pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L

Answer and Explanation

The Correct Answer is B

A. pH 7.55, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 24 mEq/L: This ABG finding indicates respiratory alkalosis, as evidenced by the elevated pH and decreased PaCO2. In progressive COPD, clients typically retain carbon dioxide rather than blow it off, so this finding would not be expected in a patient with chronic respiratory issues.
B. pH 7.30, PaCO2 60 mm Hg, PaO2 70 mm Hg, HCO3 30 mEq/L: This is the most consistent finding for a client with progressive COPD. The low pH indicates acidosis, and the elevated PaCO2 suggests respiratory acidosis due to carbon dioxide retention, a common problem in COPD. The elevated HCO3 indicates a compensatory metabolic response, as the body attempts to retain bicarbonate to buffer the acidosis.
C. pH 7.40, PaCO2 40 mm Hg, PaO2 94 mm Hg, HCO3 22 mEq/L: These values indicate a normal ABG, which would not be expected in a client with progressive COPD. Patients with chronic lung disease typically present with acid-base imbalances due to respiratory failure, so this finding suggests the client is not exhibiting the expected complications of COPD.
D. pH 7.38, PaCO2 45 mm Hg, PaO2 88 mm Hg, HCO3 26 mEq/L: Although these findings show mild acidosis, the PaCO2 is within normal limits, indicating that this patient may not be experiencing significant respiratory failure. In advanced COPD, one would expect to see a higher PaCO2 and more pronounced acidosis, making this option less characteristic of a patient with progressive COPD compared to option B.

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Correct Answer is ["A","C","D"]

Explanation

A. The medication will open the airways: Albuterol is a bronchodilator that works by relaxing the muscles around the airways, leading to dilation and increased airflow. This action helps to relieve symptoms of asthma or chronic obstructive pulmonary disease (COPD), making it easier for the client to breathe. The nurse should emphasize that opening the airways is a primary function of albuterol, providing immediate relief during breathing difficulties.
B. The medication will stimulate the flow of mucus: Albuterol does not primarily stimulate mucus production; rather, its main role is to relax bronchial smooth muscle and open the airways. While effective airway management may lead to improved mucus clearance due to enhanced airflow, albuterol itself does not directly promote mucus secretion. Thus, this statement does not accurately describe the action of the medication.
C. The medication will decrease coughing episodes: By opening the airways and improving airflow, albuterol can help reduce coughing episodes associated with bronchospasm or airway constriction. When the airways are less constricted, the client is less likely to experience the irritative cough often seen in respiratory conditions like asthma. This is an important point for the nurse to convey to help the client understand the medication's benefits.
D. The medication will prevent wheezing: Albuterol can help prevent or relieve wheezing by relaxing the bronchial muscles and facilitating better airflow. Wheezing often occurs when the airways are narrowed or constricted, and by using albuterol, the client can experience fewer wheezing episodes during respiratory distress. The nurse should explain this aspect to reinforce the medication's role in managing asthma or COPD symptoms.
E. The medication will reduce inflammation: Albuterol is not an anti-inflammatory medication; it primarily functions as a bronchodilator. While it can improve breathing by relaxing airway muscles, it does not directly target inflammation in the airways. Inhaled corticosteroids or other anti-inflammatory medications are typically used to address inflammation. Therefore, this response does not accurately reflect the action of albuterol.

A. The student's asthma is not well controlled. B. The nurse should obtain a second expiratory flow rate. C. The student needs to go to the hospital. D. The student should use his quick-relief inhaler. E. The student's peak flow is 50% to 80% of his best peak flow.

Correct Answer is ["A","D","E"]

Explanation

A. The student's asthma is not well controlled: Being in the yellow zone indicates that the student's asthma is not well controlled and that their peak expiratory flow rate (PEFR) is lower than usual. This is a crucial point for the nurse to recognize, as it suggests that the student may need to adjust their management plan to prevent an exacerbation.
B. The nurse should obtain a second expiratory flow rate: While it can be helpful to reassess peak flow rates, it is not always necessary unless there is a concern about the accuracy of the initial measurement. The initial yellow zone result provides sufficient information for the nurse to take appropriate action regarding the student's asthma management.
C. The student needs to go to the hospital: Being in the yellow zone does not automatically require hospitalization. The yellow zone typically indicates that the student is experiencing some worsening of asthma symptoms but can often be managed at home with appropriate interventions. Hospitalization is usually reserved for the red zone, where severe symptoms or a significant decrease in peak flow occurs.
D. The student should use his quick-relief inhaler: This is an appropriate action for a student in the yellow zone. The yellow zone often indicates the need for the use of a quick-relief inhaler to alleviate symptoms and improve airflow. The nurse should advise the student to use their inhaler as per their asthma action plan.
E. The student's peak flow is 50% to 80% of his best peak flow: This statement accurately describes the yellow zone, where the peak flow is between 50% and 80% of the student's personal best. This information is essential for determining the appropriate response to the current asthma status and guides the nurse's actions.

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A nurse is reviewing the arterial blood gas (ABG) result for a client diagnosed with progressive chronic obstructive pulmonary disease (COPD). The nurse should expect which of the following ABG findings for a client diagnosed with progressive COPD?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who asks how albuterol helps his breathing. Which of the following responses should the nurse make? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

A college health nurse interprets the peak expiratory flow rate for student who has asthma and finds that the student is in the yellow zone of his asthma action plan. The nurse should base her actions on which of the following information? (Select all that apply.)

Correct Answer is ["A","D","E"]

Explanation

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A nurse is reviewing the arterial blood gas (ABG) result for a client diagnosed with progressive chronic obstructive pulmonary disease (COPD). The nurse should expect which of the following ABG findings for a client diagnosed with progressive COPD?