WEEK 4 COPD

Question 1

What causes the ongoing inflammation of COPD?

Answer 1

Foreign substances

Question 2

What is the term for someone who has physiologically adapted over time and learned to live with higher levels of CO2 in their blood and lower levels of O2 in their blood​?

Answer 2

True CO2 retainer

Question 3

What is the term for a changed mechanism to trigger breathing, so that the patient now breathes when their blood O2 levels are low?

Answer 3

Hypoxic drive

Question 4

What are 3 main nursing diagnoses for COPD?

Answer 4

1. Ineffective breathing pattern
2. Ineffective gas exchange
3. Ineffective airway clearance

Question 5

What does wheezing indicate?

Answer 5

Narrowed airways

Question 6

What are 3 potential causes for narrowed airways?

Answer 6

1. Bronchospasm
2. Impaired gas exchange
3. Sputum that cannot be cleared

Question 7

What is the term for in-drawing on inspiration at junction of anterior base of neck and above clavicle?

Answer 7

Supraclavicular notching

Question 8

What are 3 things seen on x-ray that may indicate COPD?

Answer 8

1. barrel ribcage
2. flattened diaphragm
3. opacities through bronchi

Question 9

When a client has ineffective breathing pattern, how often should vitals be monitored, and how often should the lungs be auscultated?

Answer 9

q15min, and q1h

Question 10

What are 5 nursing interventions for a client with COPD experiencing insufficient gas exchange?

Answer 10

1. Monitor vitals and LOC q15min
2. Initiate O2 at 1L to achieve SpO2 88-90
3. Recheck SpO2 in 5 min, increase to 2L if necessary
4. Admin nebulizers (ventrolin, atrovent)
5. Inform physician and RT to order ABG

Question 11

What is the defining characteristic of uncomplicated respiratory acidosis?

Answer 11

Normal bicarb, as the kidneys have not compensated by retaining HCO3

Question 12

What is the defining characteristic of partially compensated respiratory acidosis?

Answer 12

Increasing bicarb, as kidneys are compensating for increasing levels of carbonic acid by retaining HCO3- and secreting H+ ions​

Question 13

What is the defining characteristic of compensated respiratory acidosis?

Answer 13

Client achieves normal baseline of elevated paCO2, decreased pH, and elevated HCO3-.

Question 14

What are 3 factors related to COPD that predispose patients to infection?

Answer 14

1. Excess sputum
2. Corticosteroids (immunosuppression)
3. Old age, poor diet

Question 15

Which lab test shows the presence of chronic inflammation in the body?

Answer 15

Erythrocyte sedimentation rate (ESR)

Question 16

Which lab test is a marker for acute inflammation in the body?

Answer 16

C-reactive protein

Question 17

Which blood test is the ratio of blood cells to plasma?

Answer 17

Hematocrit

Question 18

What are 2 reasons the RBC count may change in a patient with COPD?

Answer 18

1. Anemia due to poor nutrition and acidity
2. Erythrocytosis as a compensatory mechanism for hypoxia

Question 19

Why does a dietician need to be contacted for patients with COPD?

Answer 19

At a higher risk for malnutrition