LESSON 2

Acute Chronic obstructive Pulmonary Disease

SELF-TEST QUESTIONS

1. A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What
clinical symptoms does the nurse anticipate assessing for this patient?
a. Chest pain during respiration
b. Sputum and productive cough
c. Fever, chills, and diaphoresis
d. Tachypnea and tachycardia

2. The nurse is assigned to care for a patient with COPD with hypoxia and hypercapnia. When
planning care for this patient, what does the nurse understand is the main goal of treatment?
a. Providing sufficient oxygen to improve oxygenation
b. Avoiding the use of oxygen to decrease the hypoxic drive
c. Monitoring the pulse oximetry to assess the need for early intervention
d. Increasing pH

3. The nurse should be alert for a complication of chronic bronchitis that results from a
combination of retained secretions and obstruction and that leads to the collapse of the alveoli.
What complication should the nurse monitor for?
a. Atelectasis
b. Emphysema
c. Pleural effusion
d. Pneumonia

4. The nurse is caring for a client with emphysema in the emergency room. What does the nurse
anticipate observing for the blood gas results related to the condition?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

5. Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What
manifestations can validate the nurse’s concern? (One answer may suffice)
a. Compromised gas exchange
b. Decreased airflow
c. Wheezes
d. Jugular vein distention
e. Ascites

CRITICAL THINKING DRILL

Case Study: Emphysema
Lois, who has had emphysema, for 25 years, is admitted to the hospital with a diagnosis of
bronchitis.
A. The nurse observes that Lois has a ‘barrel chest’. What is the cause of the alteration in chest
shape and size?
Air trapping in the lungs

B. The nurse recognizes the need to be alert for what major presenting symptom of emphysema?
Dyspnea
C. The nurse is assessing the results of Lois’s arterial blood gas. Which blood gas analysis will
correlate with the diagnosis of emphysema?
pH, 7.32; PaO2, 70 mm Hg; PaCO2, 50 mm Hg
D. The health care provider prescribes oxygen therapy for Lois. What delivery system does the
nurse know will be most effective?
A Venturi mask that delivers a predictable oxygen flow at about 24%.