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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

No explanation

A. Allow the family as much time as they want with the client. B. Use paper tape to hold the client's eyelids open. C. Place the client in a supine position. D. Avoid repeating information about the client's death.

Correct Answer is A

Explanation

The nurse should allow the family as much time as they want with the client who has just died. This promotes comfort for the family and allows them to say goodbye to their loved one.

a) Using paper tape to hold the client's eyelids open is not appropriate and can be distressing for the family.

b) Placing the client in a supine position is not necessary and may not be comfortable for the client.

c) Avoiding repeating information about the client's death is not helpful. The nurse should provide clear and honest information to the family and answer any questions they may have.

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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?

Nursing Test Bank

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