The nurse is caring for a patient with a long history of chronic obstructive pulmonary disease (COPD) who develops cor pulmonale. The nurse should monitor the patient for which expected finding if heart failure is present?

Tachypnea

Cyanosis

Peripheral edema

Hypertension

Answer and Explanation

The Correct Answer is C

A. Tachypnea is a common finding in patients with COPD due to respiratory distress, but it is not specifically associated with cor pulmonale or heart failure.

B. Cyanosis, or a bluish tint to the skin, is a sign of hypoxemia and may occur in COPD, but it is not a hallmark sign of cor pulmonale.

C. Peripheral edema is a key sign of right-sided heart failure, which is common in cor pulmonale. This occurs due to the heart's inability to pump blood effectively, leading to fluid accumulation in the extremities.

D. Hypertension may be present in patients with COPD, but it is not the most specific finding related to cor pulmonale. Peripheral edema is more directly associated with the right-sided heart failure seen in cor pulmonale.

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Correct Answer is C

Explanation

A. Determining the cause of the acute exacerbation is important for long-term management but is not the priority during an emergency like status asthmaticus, where immediate interventions are required to relieve airway obstruction.

B. Administering an inhaled glucocorticoid helps reduce airway inflammation but does not act quickly enough to relieve acute bronchospasm. This is a secondary intervention after immediate relief is achieved.

C. Administering a short-acting B2-agonist (SABA) is the priority because it works rapidly to relax bronchial smooth muscles, relieve bronchospasm, and improve airflow. SABAs, such as albuterol, are the first-line treatment in acute asthma exacerbations.

D. Obtaining a peak flow reading can help assess the severity of airway obstruction, but it is not the priority during an acute emergency. Stabilizing the client’s breathing is more critical.

A. Continuous bubbling within the water seal chamber B. Fluctuation of the fluid level within the water seal chamber C. Absence of fluid in the drainage tubing D. Equal amounts of fluid drainage in each collection chamber

Correct Answer is B

Explanation

A. Continuous bubbling within the water seal chamber indicates an air leak in the system, which is not a sign of proper chest tube functioning. The nurse should investigate and address any air leaks promptly.

B. Fluctuation of the fluid level within the water seal chamber, also known as tidaling, indicates that the chest tube is functioning properly. Tidaling reflects changes in intrapleural pressure during respiration and confirms that the system is intact.

C. Absence of fluid in the drainage tubing is not an indicator of proper functioning. Depending on the client’s condition, there may or may not be fluid in the tubing. However, the system should always be assessed for patency and appropriate drainage.

D. Equal amounts of fluid drainage in each collection chamber are not expected or required. The amount of drainage depends on the client’s condition and does not indicate the functionality of the chest tube system.

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The nurse is caring for a patient with a long history of chronic obstructive pulmonary disease (COPD) who develops cor pulmonale. The nurse should monitor the patient for which expected finding if heart failure is present?

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