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Linda, a 70-year-old woman with COPD, has arterial blood gases that show a pH of 7.35, PaCO2 of 55, and Pa02 of 60. She is currently on 2 liters of oxygen via a nasal -cannula. Which of the following interventions are appropriate for Linda? Select all that apply

A.

Increase oxygen supply to 4 liters per minute via a nasal cannula.

B.

Initiate non-invasive positive pressure ventilation.

C.

Teach diaphragmatic breathing techniques.

D.

Administer a short-acting bronchodilator.

E.

Reassess arterial blood gases in 6 hours.

Answer and Explanation

Correct Answer : A,C,D,E

A.    Increasing oxygen supply to 4 liters per minute via a nasal cannula is not appropriate, as it can cause carbon dioxide retention and respiratory acidosis in COPD patients.
B.    Initiating non-invasive positive pressure ventilation is not appropriate, as it can cause barotrauma and pneumothorax in COPD patients.
 
C.    Teaching diaphragmatic breathing techniques can help Linda improve her ventilation and oxygenation by using the diaphragm more effectively.
D.    Bronchodilators can help relieve bronchospasm and improve ventilation in COPD exacerbations.
E.    Serial monitoring of arterial blood gases is essential to evaluate the effectiveness of interventions and guide further management.
 


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Explanation

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B. Suppressor T cells (T regulatory cells) are involved in modulating the immune response, but they do not generate sensitized lymphocytes or antibodies.
C. T cells play various roles in the immune response, including cell-mediated immunity, but they are not primarily responsible for generating antibodies.
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Correct Answer is ["B","D","E"]

Explanation

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C. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause a dry cough as a side effect, but it does not need to be discontinued unless there is another indication.
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E. Dietary counseling is important to prevent malnutrition and dehydration, as dysphagia can impair oral intake.

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