A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complications would the health care professional assess the patient for?
Left heart failure
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Right heart failure
The Correct Answer is D
A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.
B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.
C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.
D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","E"]
Explanation
A. Pulse oximetry 98%: A pulse oximetry reading of 98% indicates adequate oxygen saturation, which does not strongly suggest a pneumothorax. Patients with a pneumothorax may have lower oxygen saturation levels, but this reading alone is not indicative of the condition.
B. Diminished breath sounds over painful chest area: Diminished breath sounds are a significant clinical manifestation of pneumothorax, as air in the pleural space prevents normal lung expansion and decreases airflow to the affected side.
C. Respiratory rate 34: An elevated respiratory rate (tachypnea) is often observed in patients with pneumothorax as they may struggle to breathe effectively. This clinical manifestation indicates respiratory distress and is consistent with the condition.
D. ABG pH level of 7.38: A pH level of 7.38 indicates acidosis, which may occur in cases of pneumothorax due to impaired gas exchange and respiratory distress. This abnormal finding on arterial blood gases supports the suspicion of pneumothorax.
E. Asymmetrical chest movements, especially on inspiration: Asymmetrical chest movements are a classic sign of pneumothorax, where the affected lung does not expand as fully as the unaffected lung during inspiration, leading to visible differences in chest wall movement.
Correct Answer is D
Explanation
A. Pus in the pleural space: This describes empyema, a condition in which infection leads to pus accumulation in the pleural space. Empyema is commonly associated with bacterial pneumonia, lung abscess, or thoracic surgery and requires drainage and antibiotic therapy. It does not cause the lung collapse seen in pneumothorax.
B. Collapse of small airways: While airway collapse can occur in conditions like bronchiolitis or atelectasis, it is not the defining feature of pneumothorax. Pneumothorax specifically involves air leaking into the pleural space, which disrupts the negative pressure necessary for lung expansion and results in partial or complete lung collapse.
C. Blood in the chest cavity: This describes hemothorax, a condition in which blood accumulates in the pleural space due to trauma, ruptured blood vessels, or certain medical conditions. Unlike pneumothorax, which involves air in the pleural space, hemothorax requires different management, including drainage with a chest tube and possible fluid resuscitation.
D. Air in the pleural space: Pneumothorax occurs when air enters the pleural space, causing a loss of negative pressure and leading to lung collapse. This can result from chest trauma, spontaneous rupture of alveoli, underlying lung disease, or mechanical ventilation. Symptoms may include sudden chest pain, dyspnea, and decreased breath sounds on the affected side.
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