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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Pleural effusion is a common complication of heart failure. Increased pressure in the pulmonary circulation can cause fluid to accumulate in the pleural space, leading to dyspnea and decreased lung expansion.
B. Infection is not a direct complication of heart failure. However, individuals with heart failure may have an increased risk of infections due to a weakened immune system.
C. Asthma is not a complication of heart failure. While both conditions can cause shortness of breath, asthma is a separate respiratory disorder.
D. Hemorrhage is not associated with heart failure. Instead, heart failure can lead to clotting abnormalities or increased bleeding risk if the client is on anticoagulants.

A. Have client lay in bed flat for 4 hours B. Monitor site for bleeding and hematoma formation C. Administer metformin D. Administer Aspirin

Correct Answer is C

Explanation

A. Having the client lay flat for 4 hours is appropriate. After coronary angiography, bed rest is required to prevent bleeding from the arterial puncture site, especially if a femoral approach was used.
B. Monitoring the site for bleeding and hematoma formation is correct. Bleeding is a potential complication, and frequent assessment of the catheter insertion site is necessary.
C. Administering metformin should be questioned. Metformin is contraindicated within 48 hours of receiving contrast dye because of the risk of lactic acidosis, especially in clients with impaired renal function.
D. Administering aspirin is appropriate. Aspirin is commonly prescribed to prevent clot formation after a coronary procedure.

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The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

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