Which of the following is a priority goal for the client with COPD?
A. Maintaining functional ability.
B. Minimizing chest pain.
C. Increasing carbon dioxide levels in the blood.
D. Treating infectious agents.
Correct Answer: A. Maintaining functional ability
A priority goal for the client with COPD is to manage the s/s of the disease process so as to maintain the client’s functional ability. Evaluate the level of activity tolerance. Provide a calm, quiet environment. Limit a patient’s activity or encourage bed or chair rest during the acute phase. Have patient resume activity gradually and increase as individually tolerated.
Option B: Chest pain is not a typical sign of COPD. Assess and record respiratory rate, depth. Note the use of accessory muscles, pursed-lip breathing, inability to speak or converse. Useful in evaluating the degree of respiratory distress or chronicity of the disease process.
Option C: The carbon dioxide concentration in the blood is increased to an abnormal level in clients with COPD; it would not be a goal to increase the level further. Monitor arterial blood gasses values as ordered. As the patient’s condition progresses, Pa02 usually decreases. For patients with chronic carbon dioxide retention may have chronically compensated respiratory acidosis with a low normal pH and a PaCo2 higher than 50 mm Hg.
Option D: Preventing infection would be a goal of care for the client with COPD. Demonstrate and assist the patient in the disposal of tissues and sputum. Stress proper handwashing (nurse and patient), and use gloves when handling or disposing of tissues, sputum containers. Prevents spread of fluid-borne pathogens.
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