A 66-year-old female client with a diagnosis of chronic obstructive pulmonary disease

(COPD) is admitted to the health care facility for suspected pneumonia. The client gives

a history of working in a factory for 35 years and that she thinks the COPD was caused

by inhaling the fumes from the machines she worked with. Her home is near a major

highway that is always congested. The client appears well nourished, does not smoke,

and only drinks a glass of wine on social occasions. She has recently retired and is

hoping to spend time with her grandchildren. Her concern is that, for the past few days,

she has been having difficulty breathing and that she has been coughing but it is

nonproductive. She has also felt more tired than usual. At first, she thought it was a cold

or the flu but became worried when her chest started to hurt each time she took a deep

breath. Vital Signs: BP 126/82, HR 90, RR 26, Temp. 98°F (36.7°C), Pulse Ox 93%.

Questions:

a. The nurse is precepting a nursing student. The nurse asks the student to
describe changes that are frequently seen when assessing the thorax and lungs
of an older client.

b. The client asks the nurse what she should do to reduce the risk of getting
respiratory infections that could make the COPD worse. How should the nurse
respond?

c. What is the common Signs and symptoms of COPD? Why is it also known as
pink puffers?

d. How would you distinguish emphysema from COPD?