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The nurse is assessing the client diagnosed with COPD. Which of the following would require immediate attention by the nurse?

A.

Use of accessory muscles during inspiration.

B.

Large amounts of thick white sputum

C.

Presence of a barrel chest and clubbing

D.

Oxygen flowmeter set on 8 LPM

Answer and Explanation

The Correct Answer is D

A. Use of accessory muscles during inspiration is common in COPD as clients work harder to breathe. While this indicates respiratory distress, it is not necessarily an immediate emergency.  
B. Large amounts of thick white sputum can indicate mucus production, which is common in COPD. If the sputum were yellow or green, it could suggest infection, requiring further assessment.  
C. A barrel chest and clubbing are chronic changes in COPD due to prolonged air trapping and hypoxia. These findings do not require immediate intervention.  
D. Oxygen flowmeter set on 8 LPM is correct. High-flow oxygen can suppress the hypoxic drive in COPD clients, leading to respiratory depression. The nurse should immediately lower the oxygen to a safer level (typically 1-3 LPM) and monitor the client’s respiratory status.


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Related Questions

Correct Answer is C

Explanation

A. Deep vein thrombosis is not a known risk factor for obstructive sleep apnea. Sleep apnea is primarily related to airway obstruction rather than circulatory issues.
B. Being female is incorrect. Obstructive sleep apnea is more common in males than females, although postmenopausal women have an increased risk.
C. Obesity is correct. Excess weight, particularly around the neck, increases the risk of airway obstruction during sleep, making obesity a major risk factor for obstructive sleep apnea.
D. Atherosclerosis is not a direct risk factor. However, untreated obstructive sleep apnea can contribute to cardiovascular issues, including hypertension and atherosclerosis.

Correct Answer is A

Explanation

A. Metformin is correct. The combination of iodinated contrast dye and metformin increases the risk of contrast-induced nephropathy (CIN) and lactic acidosis, especially in clients with pre-existing kidney dysfunction. Metformin should be held before and after the procedure until renal function is reassessed.
B. Nitroglycerin is used for angina and does not interact with contrast dye.
C. Atorvastatin (a statin) is used for cholesterol management and has no significant interaction with contrast dye.
D. Carvedilol (a beta-blocker) is used for heart failure and hypertension but does not increase the risk of contrast-induced kidney injury.

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