The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?
Use of accessory muscles during inspiration.
Large amounts of thick white sputum
Presence of a barrel chest and clubbing
Oxygen flowmeter set on 8 LPM
The Correct Answer is D
A. Use of accessory muscles during inspiration is common in COPD as clients work harder to breathe. While this indicates respiratory distress, it is not necessarily an immediate emergency.
B. Large amounts of thick white sputum can indicate mucus production, which is common in COPD. If the sputum were yellow or green, it could suggest infection, requiring further assessment.
C. A barrel chest and clubbing are chronic changes in COPD due to prolonged air trapping and hypoxia. These findings do not require immediate intervention.
D. Oxygen flowmeter set on 8 LPM is correct. High-flow oxygen can suppress the hypoxic drive in COPD clients, leading to respiratory depression. The nurse should immediately lower the oxygen to a safer level (typically 1-3 LPM) and monitor the client’s respiratory status.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The client should notify the provider of a weight gain of 2-3 lbs in a day or 5 lbs in a week, as this may indicate fluid retention and worsening heart failure.
B. Naproxen (NSAIDs) should be avoided as they can lead to sodium retention, fluid overload, and worsening heart failure.
C. Exercising at least three times per week is correct. Regular physical activity can help improve cardiovascular function and overall endurance, provided it is within safe limits.
D. Diuretics should be taken in the morning, but not before bedtime. Taking them late can lead to nocturia and sleep disturbances.
Correct Answer is A
Explanation
A. Eating six small meals a day prevents excessive oxygen demand during digestion and reduces bloating, which can impair breathing.
B. Protein intake is important, but it does not directly impact intravascular hydrostatic pressure in a way that would help with COPD and right-sided heart failure.
C. While adequate hydration is necessary, excessive fluid intake can worsen right-sided heart failure by increasing fluid retention and edema.
D. Lying down after eating can worsen dyspnea and lead to reflux, which is not advisable for COPD patients.
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