Practice Question # 856.
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Question 1 of 1
A client with chronic obstructive pulmonary disease (COPD) is admitted to the respiratory unit. Which physician prescription should the nurse question?Correct
Answer A is correct.
Rationale: The client with COPD uses hypoxemia as a stimulus to breathe. Raising the client’s O2 blood level can suppress the respiratory drive; therefore, this is the prescription the nurse should question. Answers B, C, and D are correct physician prescriptions for COPD clients and would not need to be questioned.Incorrect
Answer A is correct.
Rationale: The client with COPD uses hypoxemia as a stimulus to breathe. Raising the client’s O2 blood level can suppress the respiratory drive; therefore, this is the prescription the nurse should question. Answers B, C, and D are correct physician prescriptions for COPD clients and would not need to be questioned.
In COPD, the airflow limitation is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. The inflammatory response occurs throughout the airways, parenchyma, and pulmonary vasculature (NIH, 2001). Because of the chronic inflammation and the body’s attempts to repair it, narrowing occurs in the small peripheral airways. Over time, this injury-and-repair process causes scar tissue formation and narrowing of the airway lumen. Airflow obstruction may also be due to parenchymal destruction as seen with emphysema, a disease of the alveoli or gas exchange units.
In addition to inflammation, processes relating to imbalances of proteinases and antiproteinases in the lung may be responsible for airflow limitation. When activated by chronic inflammation, proteinases and other substances may be released, damaging the parenchyma of the lung. The parenchymal changes may also be consequences of inflammation, environmental, or genetic factors (eg, alpha1 antitrypsin deficiency).
Early in the course of COPD, the inflammatory response causes pulmonary vasculature changes that are characterized by thickening of the vessel wall. These changes may occur as a result of exposure to cigarette smoke or use of tobacco products or as a result of the release of inflammatory mediators.