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1. Question
A nurse is giving discharge instructions to a client with pulmonary sarcoidosis. The nurse concludes that the client understands the information if the client reports which of the following early signs of exacerbation?
Correct
Answer & Rationale:
Option 4 is Correct
Rationale: Dry cough and dyspnea are typical signs and symptoms of pulmonary sarcoidosis. Others include night sweats, fever, weight loss, and skin nodules.
Test-Taking Strategy: Use the process of elimination and note the strategic word early. Because sarcoidosis is a pulmonary problem, eliminate options 1 and 3 first. Select option 4 over option 2 because the shortness of breath (and impaired ventilation) appears first and would cause the fatigue as a secondary symptom. Review the early signs of exacerbation in sarcoidosis if you had difficulty with this question.
Incorrect
Answer & Rationale:
Option 4 is Correct
Rationale: Dry cough and dyspnea are typical signs and symptoms of pulmonary sarcoidosis. Others include night sweats, fever, weight loss, and skin nodules.
Test-Taking Strategy: Use the process of elimination and note the strategic word early. Because sarcoidosis is a pulmonary problem, eliminate options 1 and 3 first. Select option 4 over option 2 because the shortness of breath (and impaired ventilation) appears first and would cause the fatigue as a secondary symptom. Review the early signs of exacerbation in sarcoidosis if you had difficulty with this question.
pulmonary disease
A disease state characterized by pulmonary airflow obstruction that is usually progressive, not fully reversible, and sometimes accompanied by airway hyperreactivity. Airflow obstruction may be caused by chronic bronchitis and/or emphysema. In chronic hypercapnia, the stimulus to breathe is a low PO2 instead of an increased PCO2.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Description
Also known as chronic obstructive lung disease and chronic airflow limitation
Chronic obstructive pulmonary disease is a disease state characterized by airflow obstruction caused by emphysema or chronic bronchitis.
Progressive airflow limitation occurs, associated with an abnormal inflammatory response of the lungs that is not completely reversible.
Chronic obstructive pulmonary disease leads to pulmonary insufficiency, pulmonary hypertension, and cor pulmonale.
Assessment
Cough
Exertional dyspnea
Wheezing and crackles
Sputum production
Weight loss
Barrel chest (emphysema) (Fig. 58-11)
Use of accessory muscles for breathing
Prolonged expiration
Orthopnea
Cardiac dysrhythmias
Congestion and hyperinflation seen on chest xray
ABG levels that indicate respiratory acidosis and hypoxemia
