A nurse is providing a presentation to colleagues on emphysema. Which of the following subtypes should the nurse identify as having a complication of pneumothorax?

A. Chronic pulmonary disease: Chronic pulmonary disease, such as COPD, affects the lungs and respiratory system but is not a primary risk factor for peripheral artery disease (PAD), which is caused by atherosclerosis affecting peripheral circulation.
B. Rheumatic fever: Rheumatic fever is associated with inflammatory damage to the heart valves due to a streptococcal infection, but it does not increase the risk of developing PAD, which is vascular in nature and primarily driven by atherosclerotic risk factors.
C. Body mass index of 35: A BMI of 35 indicates obesity, which significantly increases the risk for atherosclerosis and related conditions like PAD. Obesity contributes to poor lipid profiles, hypertension, and insulin resistance, all of which promote arterial narrowing and plaque buildup.
D. History of venous thrombosis: Venous thrombosis affects the venous system and is different from arterial disease. While it may signal vascular issues, it is not considered a direct risk factor for PAD, which involves arterial—not venous—occlusion.

A. Swelling of the optic nerve: Swelling of the optic nerve, also known as papilledema, is a clear sign of increased intracranial pressure and indicates a worsening neurological condition. It results from pressure transmitted through the cerebrospinal fluid, leading to compromised optic nerve function.
B. Respiratory rate of 12/min: A respiratory rate of 12 breaths per minute is within normal limits for adults and does not indicate deterioration. While respiratory changes can be a late sign of increased ICP, a rate of 12 alone is not concerning.
C. Changes to pupil size and shape: Alterations in pupil size and shape often reflect pressure on cranial nerves, particularly the oculomotor nerve (CN III), which is a critical warning sign of brain herniation or increased ICP. This is a significant cue of neurologic decline.
D. Blood pressure of 108/74 mm Hg: This blood pressure reading is within a normal range and does not independently suggest a worsening neurologic condition. Worrisome signs would include widened pulse pressure or elevated systolic pressure, which may signal Cushing’s triad.
E. Decreasing Glasgow Coma scores: A drop in the Glasgow Coma Scale score indicates a decline in consciousness, which is a key sign of worsening intracranial pathology. Monitoring GCS trends is essential in patients with increased ICP to identify neurological deterioration early.