COPD, asthma, and pneumonia nursing assessment priorities and interventions on the medical-surgical floor, distinct from the ICU ventilator-management deck.
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- In a patient having a COPD exacerbation, what physical sign shows increased work of breathing?
- Use of accessory muscles (neck and shoulder muscles) to breathe
- For a stable COPD patient, what oxygen saturation range should a nurse target with supplemental oxygen?
- 88-92%
- Why must a nurse use caution giving high-flow oxygen to a chronic CO2-retaining COPD patient?
- It can suppress the hypoxic drive to breathe, worsening hypoventilation
- What is the purpose of pursed-lip breathing in COPD?
- It keeps airways open longer and slows exhalation to reduce air trapping
- Why do COPD patients often lean forward with arms braced (tripod position)?
- It maximizes accessory muscle use and improves lung expansion
- Chronic air trapping in COPD leads to a ____ deformity.
- barrel chest
- Finger clubbing in a respiratory patient is a sign of what underlying problem?
- Chronic hypoxia
- What acid-base pattern is expected on ABG in a patient with stable chronic COPD?
- Compensated respiratory acidosis (near-normal pH, elevated CO2, elevated bicarbonate)
- Ipratropium is an example of which class of inhaled bronchodilator?
- Anticholinergic
- Why are systemic corticosteroids given during a COPD exacerbation?
- To reduce airway inflammation
- What is the single most important intervention to slow the progression of COPD?
- Smoking cessation
- Absent contraindications, about how much daily fluid intake is recommended for a COPD patient to help thin secretions?
- 2 to 3 liters per day
- Why should a COPD patient eat small, frequent meals instead of large ones?
- A full stomach can limit diaphragm movement and worsen dyspnea
- What is the priority nursing concern for a patient in acute COPD exacerbation?
- Impaired gas exchange
- What term describes the elevated resting respiratory rate often seen in COPD patients trying to compensate for poor gas exchange?
- Tachypnea