A nurse is collecting data for a client who has COPD. The nurse should expect the client's chest to be which of the following shapes?

A. Place the client in left Sims' position.

Left Sims' position is a lateral position used primarily for rectal examinations or procedures. It involves lying on the left side with the lower arm positioned behind the body and the upper knee flexed. This position is not indicated for a client post-tracheostomy. It does not provide any specific benefit for tracheostomy care and may not be comfortable or appropriate for a client recovering from tracheostomy surgery.

B. Provide humidified air.

Providing humidified air is crucial for clients post-tracheostomy to maintain moisture in the airway and prevent drying of secretions. Tracheostomy bypasses the upper airway's natural humidification mechanism, which can lead to drying of the mucous membranes and increased risk of complications such as mucus plugging and infection. Humidified air helps keep the secretions moist, facilitates their removal, promotes airway clearance, and reduces the risk of complications.

C. Clean the tracheostomy stoma with povidone-iodine.

While povidone-iodine is an antiseptic solution commonly used for skin preparation before invasive procedures, it is not typically used to clean the tracheostomy stoma, especially in the immediate postoperative period. Cleaning the stoma should be performed using sterile technique and appropriate solutions as directed by the healthcare provider. Using povidone-iodine may not be suitable for cleaning the tracheostomy stoma and could potentially irritate the area or introduce contaminants.

D. Use clean technique when providing tracheostomy suctioning.

Tracheostomy suctioning should always be performed using sterile technique to minimize the risk of introducing pathogens into the lower airway and causing infection. Clean technique, which involves washing hands and using clean gloves, is not appropriate for tracheostomy care, particularly in the immediate postoperative period when the risk of infection is higher. Sterile technique involves the use of sterile gloves, sterile suction catheters, and maintaining a sterile field to ensure the safety and cleanliness of the procedure.

A. Dyspnea: Dyspneais a hallmark symptom of emphysema. As lung function deteriorates, the client experiences difficulty breathing, especially during exertion, due to reduced gas exchange and air trapping in the lungs.

B. Barrel chest:A barrel chest is a common finding in emphysema due to hyperinflation of the lungs over time. This causes the chest to become rounded and expands the anterior-posterior diameter of the thorax.

C. Clubbing of the fingers: Clubbing of the fingers is not a typical finding in emphysema or COPD. It is more commonly associated with conditions like lung cancer, cystic fibrosis, or congenital heart disease, where chronic severe hypoxia is present.

D. Shallow respirations:Clients with emphysema often exhibit shallow respirations as their lung elasticity decreases, making it difficult to fully exhale. As a result, breathing may become more rapid and shallow to compensate for poor oxygen exchange.

E. Bradycardia: Bradycardiais not typically associated with emphysema. Instead, clients with chronic respiratory conditions like emphysema may experience tachycardiaas the body tries to compensate for low oxygen levels.