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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 D

Explanation

The nurse should recommend that the client who has diminished breath sounds and paradoxical chest movement receive care first. This client is likely experiencing a tension pneumothorax, which is a life-threatening condition that requires immediate intervention.

Option a is incorrect because a client who has a head injury and whose pupils are fixed and dilated may have experienced brain death and may not be able to be resuscitated.

Option b is incorrect because a dislocated shoulder, while painful, is not immediately life-threatening. Option c is incorrect because a scalp laceration with intermittent bleeding can be managed with pressure and is not immediately life-threatening.

A. Potatoes B. Corn C. Oranges D. Grapes

Correct Answer is D

Explanation

Grapes are a common choking hazard for young children, especially toddlers, due to their small size, round shape, and slippery texture. The size and shape of grapes can block the airway and pose a significant risk if not properly cut or prepared before being given to a toddler. It is recommended to cut grapes into small pieces or slice them lengthwise to reduce the risk of choking.

While potatoes, corn, and oranges can also pose a choking risk if not properly prepared or cut into age-appropriate sizes, they are not as commonly associated with choking incidents in toddlers as grapes are. Nonetheless, it is essential for parents and caregivers to be aware of appropriate food preparation techniques and supervise children during meals to ensure their safety.

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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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