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Questions and Answers
A patient with COPD has chronic bronchitis. Which clinical feature is most associated with this condition?
A patient with COPD has chronic bronchitis. Which clinical feature is most associated with this condition?
What symptom is most indicative of emphysema in a COPD patient?
What symptom is most indicative of emphysema in a COPD patient?
Which is the primary risk factor for developing COPD?
Which is the primary risk factor for developing COPD?
Which pulmonary function test (PFT) finding is consistent with COPD?
Which pulmonary function test (PFT) finding is consistent with COPD?
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A nurse administers a beta-2 adrenergic agonist to a patient with COPD. What is the primary therapeutic action of this drug?
A nurse administers a beta-2 adrenergic agonist to a patient with COPD. What is the primary therapeutic action of this drug?
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What should a nurse include when teaching a patient about the use of an MDI (metered-dose inhaler)?
What should a nurse include when teaching a patient about the use of an MDI (metered-dose inhaler)?
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A patient taking albuterol reports insomnia and nervousness. How should the nurse respond?
A patient taking albuterol reports insomnia and nervousness. How should the nurse respond?
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Which intervention helps to loosen secretions in a COPD patient?
Which intervention helps to loosen secretions in a COPD patient?
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Why must oxygen therapy be used cautiously in COPD patients with chronic hypercarbia?
Why must oxygen therapy be used cautiously in COPD patients with chronic hypercarbia?
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Which is the most common cause of COPD exacerbations?
Which is the most common cause of COPD exacerbations?
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Which nursing action helps promote airway clearance in a patient with COPD?
Which nursing action helps promote airway clearance in a patient with COPD?
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What is a hallmark sign of chronic bronchitis in COPD?
What is a hallmark sign of chronic bronchitis in COPD?
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A patient is prescribed tiotropium bromide for COPD. What class of medication is this?
A patient is prescribed tiotropium bromide for COPD. What class of medication is this?
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What dietary advice should the nurse give to a patient with COPD?
What dietary advice should the nurse give to a patient with COPD?
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What benefit can a COPD patient expect from smoking cessation after diagnosis?
What benefit can a COPD patient expect from smoking cessation after diagnosis?
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Which statement indicates a need for further teaching about home oxygen use?
Which statement indicates a need for further teaching about home oxygen use?
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Which factor is a modifiable risk for developing COPD?
Which factor is a modifiable risk for developing COPD?
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What is the primary purpose of pursed-lip breathing in COPD patients?
What is the primary purpose of pursed-lip breathing in COPD patients?
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A nurse advises a patient with COPD to pace activities. What is the primary goal of this intervention?
A nurse advises a patient with COPD to pace activities. What is the primary goal of this intervention?
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A patient taking inhaled corticosteroids for COPD should be taught to:
A patient taking inhaled corticosteroids for COPD should be taught to:
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Why is anxiety common in COPD patients?
Why is anxiety common in COPD patients?
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Which surgical option is considered for severe COPD?
Which surgical option is considered for severe COPD?
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What type of diet should a nurse recommend for a COPD patient?
What type of diet should a nurse recommend for a COPD patient?
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How can COPD patients prevent respiratory infections?
How can COPD patients prevent respiratory infections?
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What is the therapeutic range for theophylline in COPD management?
What is the therapeutic range for theophylline in COPD management?
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Which symptom indicates a COPD exacerbation?
Which symptom indicates a COPD exacerbation?
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What is the best position for a patient experiencing dyspnea?
What is the best position for a patient experiencing dyspnea?
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What is the primary purpose of administering mucolytics in COPD?
What is the primary purpose of administering mucolytics in COPD?
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What arterial blood gas (ABG) finding is consistent with COPD?
What arterial blood gas (ABG) finding is consistent with COPD?
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What is a realistic long-term goal for a patient with COPD?
What is a realistic long-term goal for a patient with COPD?
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Study Notes
COPD Practice
- Pathophysiology of COPD: A persistent productive cough is the most significant clinical feature associated with chronic bronchitis.
- Chronic Bronchitis: Characterized by excessive mucous production leading to a continuous cough lasting at least 3 months for 2 consecutive years.
- Emphysema: Pursed-lip breathing, is a key indicator of emphysema in COPD patients. It's a compensatory mechanism to assist expiration and reduce air trapping.
Clinical Manifestations
- Emphysema: Pursed lip breathing is a prominent symptom in emphysema patients.
- Chronic Bronchitis: Characteristic symptom is a persistent, productive cough.
- COPD in General: Large amounts of sputum may be present.
Risk Factors
- Principal Risk Factor: Cigarette smoking is the leading cause of COPD, approximately 80% of cases.
- Other Factors: Alpha-1 antitrypsin deficiency, exposure to air pollutants, and occupational irritants are also risk factors.
Diagnostic Testing
- Key Pulmonary Function Test: Decreased FEV1/FVC ratio is a diagnostic indicator of COPD. It measures the airflow limitation.
Pharmacologic Therapy
- Beta-2 adrenergic agonist: The primary therapeutic action is relaxing bronchial smooth muscles promoting bronchodilation.
Nursing Education
- Inhaler Usage: Inhaled medications, such as MDI, should be administered by holding the breath for 5-10 seconds after inhalation to maximize drug delivery to the lungs.
Side Effects of Beta-2 Agonists
- Common Side Effects: Insomnia and nervousness are common side effects of Beta-2 agonists. Nurses should inform patients about these possible side effects.
Non-pharmacologic Management
- Secretion Management: Postural drainage is a nonpharmacological intervention that assists in loosening and removing secretions. This is done using gravity.
Oxygen Therapy
- Cautious Use: Oxygen therapy should be utilized carefully in COPD patients experiencing chronic hypercarbia due to risk of suppressing their hypoxic drive/breathing.
COPD Exacerbation Management
- Common Cause: Viral or bacterial infections commonly trigger COPD exacerbations.
COPD Nursing Actions
- Hydration: Encourage fluid intake (over 2000 mL/day) to thin lung secretions, making expectoration easier.
Clinical Manifestations (COPD)
- Chronic Bronchitis Hallmark: Cyanosis is a hallmark of chronic bronchitis, stemming from inadequate oxygenation, usually indicated/visibly shown by bluish skin tone.
Pharmacologic Therapy (Continued)
- Tiotropium Bromide (Spiriva): A common COPD medication, classification as an anticholinergic bronchodilator, relaxes bronchial muscles, and decreases mucous production.
Non-pharmacologic Therapy
- Dietary Recommendations: Patients with COPD should follow a high-calorie, high-protein diet to meet high energy demands of breathing.
Smoking Cessation
- Positive Outcome: Smoking cessation prevents further lung damage and slows the progression of COPD.
Oxygen Therapy (Continued)
- Oxygen Safety: Avoid using petroleum-based products (like petroleum jelly) while using oxygen, as they are flammable.
Risk Factors (Continued)
- Modifiable Risk Factors: Cigarette smoking is a modifiable risk factor for developing COPD.
Pursed-Lip Breathing
- Purpose: Pursed-lip breathing is a technique used to assist in preventing airway collapse during exhalation, preventing air trapping, and promoting proper breathing.
Activity Management
- Goal: Energy conservation strategies for pacing activities effectively to decrease fatigue associated with the work of breathing.
Corticosteroid Use
- Post-Use Care: Patients taking inhaled corticosteroids should rinse their mouth after each use to prevent oral thrush (a side effect).
Anxiety in COPD
- Underlying Reason: Progressive and irreversible nature of COPD contributes to higher anxiety.
Surgical Interventions
- Severe COPD Treatment: Lung volume reduction surgery is considered in severe cases of COPD to remove diseased lung tissue, improving function.
COPD Diet (Continued)
- Nutritional Needs: High-calorie, high-protein diet is recommended to meet the increased nutritional needs associated with COPD.
COPD and Infection
- Infection Prevention: Avoiding crowded places and sick contacts, along with practicing good hygiene (handwashing, covering mouth when coughing/sneezing), helps prevent respiratory infections.
Medication Monitoring
- Theophylline Range: The therapeutic range for theophylline in COPD management is typically 10–20 mcg/mL.
COPD Exacerbations
- Symptom Indication: Worsening dyspnea is a noticeable indicator of a COPD exacerbation.
Patient Positioning
- Optimal Positioning: High-Fowler's position is the optimal position for patients with dyspnea to maximize lung expansion.
Mucolytic Therapy
- Primary Purpose/Action: Mucolytics are primarily used for thinning and loosening mucus, facilitating expectoration (coughing up mucus).
Monitoring ABGs
- COPD Indicator: COPD can often cause CO2 retention, leading to respiratory acidosis, evidenced by an arterial blood gas (ABG) analysis.
Long-Term Goals
- Realistic Goal: Maintaining an oxygen saturation level above 90% is a realistic long-term goal for COPD patients, indicating good oxygenation.
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Description
Test your knowledge on Chronic Obstructive Pulmonary Disease (COPD), including its pathophysiology, clinical manifestations, and risk factors. This quiz covers key aspects of both emphysema and chronic bronchitis, highlighting significant symptoms and causes. Enhance your understanding of this common respiratory condition.
