Comprehensive Respiratory System Disorders Q 16

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Which of the following outcomes would be appropriate for a client with COPD who has been discharged to home? The client:

  

     A. Promises to do pursed lip breathing at home.

     B. States actions to reduce pain.

     C. States that he will use oxygen via a nasal cannula at 5 L/minute.

     D. Agrees to call the physician if dyspnea on exertion increases.

    

    

Correct Answer: D. Agrees to call the physician if dyspnea on exertion increases.

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Increasing dyspnea on exertion indicates that the client may be experiencing complications of COPD, and therefore the physician should be notified. There are things that everyone with COPD should do to manage their disease; quitting smoking (if they smoke) is the most important. In addition, there are other non-medication treatments that can help relieve symptoms and improve quality of life.

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Option A: Extracting promises from clients is not an outcome criterion. Pulmonary rehabilitation programs have been shown to improve a person’s ability to exercise, enhance quality of life, and decrease the frequency of COPD exacerbations (when symptoms flare up more than usual). Even people with severe shortness of breath can benefit from a rehabilitation program.

Option B: Pain is not a common symptom of COPD. Although COPD usually worsens over time, it is difficult to predict how quickly it will progress and how long the client will live (the prognosis). A number of factors play a role in the severity of COPD symptoms, including whether the client continues to smoke, are underweight, or have other medical problems, and how the lungs function during exercise. People with COPD who have less severe symptoms, are a healthy weight, and do not smoke tend to live longer.

Option C: Clients with COPD use low-flow oxygen supplementation (1 to 2 L/minute) to avoid suppressing the respiratory drive, which, for these clients, is stimulated by hypoxia. People with severe or advanced COPD can have low oxygen levels in the blood. This condition, known as hypoxemia, can occur even if the client does not feel short of breath or have other symptoms. The oxygen level can be measured with a device placed on the finger (pulse oximeter) or with a blood test (arterial blood gas). People with hypoxemia may be placed on oxygen therapy, which can improve survival and quality of life.

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