A nurse is caring for a client who has chronic respiratory acidosis due to chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect with this client?

Choice A Reason:

Chronic cough is correct. Persistent cough is a common symptom of COPD, often occurring due to irritation and inflammation in the airways.

Choice B Reason:

Sputum production is correct. COPD patients frequently experience increased mucus production, leading to coughing up phlegm or sputum, especially in the morning.

Choice C Reason:

Dyspnea is correct. Shortness of breath or dyspnea is a hallmark symptom of COPD, particularly during physical activity or exertion, and it tends to worsen as the disease progresses.

Choice D Reason:

Wheezing occurs due to narrowed airways and increased airway resistance. It is more noticeable during expiration but can also be present during inspiration in severe cases.

Choice E Reason:

Chest tightness is incorrect. While chest tightness can occur in COPD, it is typically more associated with asthma. However, some individuals with COPD may experience chest tightness, especially during exacerbations or when airflow is significantly limited.

Choice A Reason:

Prothrombin time (PT) is a laboratory test that measures the time it takes for blood to clot is incorrect. While PT may be part of a comprehensive evaluation in some cases, it is not typically the initial diagnostic test performed for a TIA. A TIA is caused by a temporary disruption of blood flow to the brain, often due to an embolus or transient blockage in a cerebral artery, rather than a primary disorder of blood clotting.

Choice B Reason:

Complete blood count (CBC) is incorrect. A complete blood count (CBC) is a common laboratory test that evaluates the cellular components of the blood, including red blood cells, white blood cells, and platelets. While CBC can provide valuable information about hematological conditions such as anemia or thrombocytosis, it is not specific to diagnosing the cause of a TIA. TIA is primarily a vascular event related to transient ischemia in the brain rather than a disorder of blood cell counts.

Choice C Reason:

Computerized tomography angiography (CTA) is appropriate. CTA is a non-invasive imaging test that combines computed tomography (CT) scanning with contrast dye to visualize blood vessels throughout the body, including those in the brain. CTA can help identify any blockages, narrowing, or abnormalities in the blood vessels supplying the brain, which may be contributing to the TIA. It provides detailed images of the blood vessels' structure and can help guide further management and treatment decisions.

Choice D Reason:

Transesophageal echocardiogram (TEE) is inappropriate. Transesophageal echocardiogram (TEE) is an imaging test that provides detailed images of the heart and major blood vessels using sound waves. While TEE may be indicated in some cases of TIA to evaluate for potential cardiac sources of emboli (blood clots), such as atrial fibrillation or cardiac valve abnormalities, it is not typically the first-line diagnostic test performed in the emergency department setting for evaluating a TIA. Initial imaging studies such as CTA or magnetic resonance imaging (MRI) of the brain are usually prioritized to assess for acute changes in cerebral blood flow and potential causes of the TIA.