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A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?

Hgb 20 g/dL

Oxygen saturation 92%

Productive cough with green sputum

Chest x-ray shows hyperinﬂation of lungs

Answer and Explanation

The Correct Answer is A

Answer: A

Rationale:

A) Hgb 20 g/dL:

A hemoglobin level of 20 g/dL is elevated and suggests polycythemia, which can occur in chronic respiratory conditions like COPD due to chronic hypoxia. Elevated hemoglobin levels can increase blood viscosity, leading to complications such as increased risk of thrombosis and cardiovascular stress. This finding indicates a potentially serious issue and should be reported to the healthcare provider immediately to address any underlying causes and manage the client's condition effectively.

B) Oxygen saturation 92%:

An oxygen saturation of 92% is slightly below the typical normal range (95-100%) but is not immediately life-threatening. While it indicates mild hypoxemia, it is a common finding in COPD patients, and the management would typically involve supplemental oxygen or adjustment of therapy. This finding should be monitored but is not the most critical issue to report immediately.

C) Productive cough with green sputum:

A productive cough with green sputum suggests a possible infection or exacerbation of COPD. Although this is an important finding that requires evaluation and possible treatment, it is less critical than an elevated hemoglobin level, which indicates a more acute systemic issue. The green sputum should be reported and managed, but it is not the priority compared to the elevated hemoglobin.

D) Chest x-ray shows hyperinflation of lungs:

Hyperinflation of the lungs is a common radiological finding in COPD due to air trapping. While it is a significant finding, it is generally consistent with the disease's progression and does not indicate an acute problem requiring immediate intervention. Monitoring and managing the underlying COPD are necessary, but this finding is less urgent than the elevated hemoglobin.

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Correct Answer is B

Explanation

b. Platelet count 90,000/mm3.

Explanation:

During pregnancy, it is important to monitor the client's platelet count because a low platelet count can indicate a condition called gestational thrombocytopenia or other potential complications such as preeclampsia or HELLP syndrome. A platelet count of 90,000/mm3 is lower than the normal range and should be reported to the provider for further evaluation and management.

Option a, Hgb 12 g/dL, falls within the normal range for hemoglobin during pregnancy, which is typically between 11-13.5 g/dL. Therefore, it does not require immediate notification to the provider.

Option c, Hematocrit 37%, also falls within the normal range for hematocrit during pregnancy, which is typically between 33-42%. Therefore, it does not require immediate notification to the provider.

Option d, Creatinine 0.7 mg/dL, is within the normal range for creatinine levels and does not indicate any immediate concerns or need for notification to the provider.

It is important to remember that the interpretation of laboratory results should be done in the context of the client's individual clinical presentation and the healthcare provider's assessment. Any concerns or abnormal findings should be communicated to the provider for further evaluation and appropriate management.

A. Schedule the medication at meal times. B. Request the family talk to the provider about administering the medication by injection. C. Inform the family that the client has the right not to take the medication. D. Ask the family what foods the client likes.

Correct Answer is C

Explanation

The nurse should inform the family that the client has the right to refuse medication. It is important to

respect the client's autonomy and right to make decisions about their own care.

a) Scheduling the medication at meal times does not address the issue of the client refusing their medication.

b) Requesting that the family talk to the provider about administering the medication by injection may be an option, but it does not address the issue of informed consent.

d) Asking the family what foods the client likes does not address the issue of informed consent and could be seen as a way to deceive the client into taking their medication.

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A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?

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