The nurse is caring for a client with an exacerbation of COPD and scheduled for pulmonary function studies using a spirometer. Which client statement would the nurse clarify?

A. Monitor heart rhythm: While cardiac monitoring is important, it doesn’t directly assess airway status or ventilation. Respiratory compromise must be identified through airway-focused assessments.
B. Auscultate lung sounds: Hourly lung auscultation helps detect early signs of airway obstruction, stridor, or atelectasis. It’s the most direct way to monitor for post-extubation respiratory issues.
C. Assess capillary refill: Capillary refill assesses peripheral perfusion but gives little information about airway patency or breathing effectiveness after extubation.
D. Obtain vital signs: Vital signs are useful but may not change until respiratory compromise becomes severe. Lung assessment provides earlier clues of deterioration.

A. History of thrombophlebitis in both extremities: This is a non-modifiable risk factor. Prior venous inflammation or clotting increases susceptibility to varicose veins but cannot be changed through lifestyle modifications.
B. Mother and maternal grandmother had varicose veins: Family history reflects genetic predisposition and is a non-modifiable factor. Inherited vein wall weakness increases risk but cannot be influenced by behavior.
C. Employed as an over-the-road truck driver: Prolonged sitting or standing restricts venous return and contributes to vein distension. This is modifiable through frequent leg movement, walking breaks, and use of compression stockings.
D. Weight gained during past pregnancies: Weight gain during previous pregnancies is a past event and no longer modifiable. Although pregnancy increases venous pressure, current lifestyle changes can't alter that history.