A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

Increased arterial oxygen

Increased pH

Increased carbon dioxide

Decreased alveolar function

Answer and Explanation

The Correct Answer is C

A. Increased arterial oxygen: Clients with COPD typically experience chronic hypoxemia due to alveolar destruction, airway inflammation, and mucus production, which impair gas exchange. Rather than increased oxygen levels, they often have a decreased PaO₂, requiring supplemental oxygen therapy. However, excessive oxygen administration can suppress their respiratory drive, worsening CO₂ retention.
B. Increased pH: COPD is associated with respiratory acidosis due to chronic CO₂ retention from inadequate alveolar ventilation. While the kidneys compensate by increasing bicarbonate retention, the pH usually remains low or near normal in chronic cases rather than becoming elevated. A higher pH would indicate alkalosis, which is not typical in COPD unless there is an additional metabolic disturbance.
C. Increased carbon dioxide: COPD causes airway obstruction and reduced alveolar ventilation, leading to CO₂ retention (hypercapnia). As CO₂ accumulates in the blood, it lowers the pH, resulting in respiratory acidosis. Chronic hypercapnia is a hallmark of advanced COPD, and in response, the kidneys retain bicarbonate to partially compensate, stabilizing the pH over time but leaving PaCO₂ elevated.
D. Decreased alveolar function: While COPD does lead to progressive alveolar damage and reduced gas exchange, this is a structural and functional change rather than a specific abnormality seen in arterial blood gases. The primary ABG finding in COPD is hypercapnia, which reflects inadequate ventilation and CO₂ retention rather than just decreased alveolar function alone.

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Correct Answer is A

Explanation

A. Incentive spirometry: This is the most effective independent nursing measure to prevent atelectasis. Incentive spirometry encourages deep breathing and lung expansion, which helps to keep the alveoli open and reduces the risk of collapse. It is particularly beneficial for clients at risk for atelectasis, such as those who have had surgery, are immobile, or have respiratory issues. Regular use of the incentive spirometer promotes optimal lung function and helps prevent the development of atelectasis.
B. Increase oral fluid intake: While maintaining adequate hydration is important for overall health and can help thin secretions, it is not as directly effective in preventing atelectasis as incentive spirometry. Increased fluid intake alone does not promote deep breathing or lung expansion, which are critical in preventing airway collapse.
C. Ambulation: Although ambulation is an important intervention for promoting overall mobility and respiratory function, it may not be as practical for all clients, especially those who are unable to move independently. While getting the client up and moving can help prevent atelectasis, the most immediate and effective measure remains the use of incentive spirometry, which can be performed regardless of the client’s mobility status.
D. Oxygen therapy: While oxygen therapy can help improve oxygenation in clients with respiratory issues, it does not directly prevent atelectasis. Providing supplemental oxygen does not address the need for lung expansion and deep breathing, which are essential in maintaining alveolar patency. Therefore, oxygen therapy should not be prioritized as the primary independent measure to prevent atelectasis.

Correct Answer is []

Explanation

Asthma: The client’s symptoms of wheezing, chest tightness, and persistent dry cough, especially worsening at night, are characteristic of asthma. The presence of bilateral wheezing and a low pulse oximetry reading of 90% indicate that the client is experiencing bronchoconstriction and reduced airflow, which are hallmark features of an asthma exacerbation.
Plan to administer bronchodilator: Administering a bronchodilator is essential in treating asthma as it helps relax the bronchial muscles, leading to bronchodilation and improved airflow. This intervention is crucial for alleviating wheezing and shortness of breath associated with an asthma attack.
Measure the client's peak airflow: Measuring peak airflow using a peak flow meter helps assess the severity of the asthma and the effectiveness of the bronchodilator therapy. It provides objective data on the client’s lung function, allowing the nurse to evaluate changes in the client’s condition over time and make necessary adjustments to the treatment plan.
Prepare to administer an antibiotic: This action is not appropriate for asthma since antibiotics are ineffective against viral conditions and are typically used for bacterial infections such as pneumonia. Since the client is experiencing asthma symptoms rather than an infection, this intervention does not address the underlying problem.
Request a prescription for a diuretic: This action is also not appropriate in this scenario. Diuretics are used to manage fluid overload conditions, such as pulmonary edema or heart failure, and would not be indicated for a client with asthma experiencing wheezing and shortness of breath.
Teach the client pursed lip breathing: This technique is more commonly used in COPD to prevent airway collapse rather than in asthma, where bronchodilators provide more immediate relief.
Oxygen saturation: Monitoring oxygen saturation is critical for assessing the effectiveness of treatment in clients with asthma. A low oxygen saturation level indicates inadequate oxygenation, which necessitates immediate intervention. Tracking this parameter helps ensure the client is receiving adequate oxygen during their treatment.
Pulmonary function tests: While pulmonary function tests are useful for assessing long-term lung function, they provide valuable information on how well the lungs are functioning. Pulmonary function tests (PFTs), including forced expiratory volume in one second (FEV1) and peak expiratory flow rate (PEFR), help evaluate the degree of airway obstruction and response to treatment. Monitoring PFTs over time provides insight into asthma control and treatment effectiveness.
Weight: Monitoring weight is not a primary concern in managing asthma exacerbations. While it can be relevant in certain chronic conditions or for assessing fluid retention, it is not directly related to monitoring respiratory status or the effectiveness of asthma treatment.
Temperature: While it is important to monitor temperature in general to identify potential infections, it is not specifically relevant to assessing asthma status unless there are other indications of an underlying infection contributing to the respiratory symptoms. In the context of asthma management, oxygen saturation and peak airflow are more critical parameters.
Urine output: Monitoring urine output is not a direct indicator of asthma status. It is more relevant in assessing kidney function and fluid balance, which are not primary concerns in the acute management of asthma exacerbations.
COPD typically presents with a long history of smoking, chronic cough, and progressive respiratory symptoms. In this scenario, the client is a nonsmoker, and the acute nature of the symptoms is more indicative of asthma rather than COPD.
Pulmonary edema often presents with symptoms such as cough with frothy sputum, severe shortness of breath, and hypoxia, typically related to heart failure. The client’s symptoms are more consistent with asthma rather than fluid overload.
Pneumonia: Pneumonia usually presents with symptoms such as productive cough, fever, chills, and localized lung findings. While wheezing can occur, the lack of fever and the specific nighttime worsening of symptoms align more closely with asthma than with pneumonia.
Asthma: The client’s symptoms of wheezing, chest tightness, and dry cough, especially worsening at night, are characteristic of asthma. The presence of bilateral wheezing and a low pulse oximetry reading indicate bronchoconstriction and reduced airflow, consistent with an asthma exacerbation.

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A nurse is reviewing arterial blood gas results for a client diagnosed with chronic obstructive pulmonary disease (COPD). The nurse should expect which abnormal finding?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client at risk for atelectasis. Which independent nursing measure should the nurse prioritize to prevent atelectasis development?

Correct Answer is A

Explanation

Correct Answer is []

Explanation

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