BNKN602 - NURSING THE PERSON WITH COPD EXAM
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
What are the two main characteristics of COPD
emphysema and chronic bronchitis
What is emphysema
loss of elasticity allows alveolu to expand with inspiration but reduces its ability to recoil
with exiration. this results in co2 being trapped and increases alveolar pco2
What results due to an increased PCO2
co2 cannot diffuse readily from pulmonary capillaries causing a build up of co2 in
arterial blood and results in hypercapnia. accumulation of damage causes large spaces
to develop which reduces surface area and decreases gas exchange between alveoli
and pulmonary capillaries
Expected airway findings of exacerbation of copd
airway patent but potentially under threat if decreased level of conciousness due to
hypercapnia and hypoxaemia
Expected breathing findings of exacerbation of copd
increased WOB due to hypercapnia, pursed lip breathing, tachypnoeic, sp02 <90% due
to hypoxaemia, upright or tripod position to expand thoracic cavity and maximise air
entry for gas exchange, adventitious sounds - wheeze due to bronchoconstriction,
, possible decreased air entry due to alveolar collapse, resonant percussion due to
hyperinflation
Expected circulation findings of acute exacerbation of COPD
cool pale peripheries and/or cyanosis due to hypoxaemia, CRT >3 seconds due to
peripheral vasoconstriction, possible elevated temperature due to increased metabolic
rate or infection, diaphoresis due to increased WOB or hypercapnia, tachycardia due to
hypoxaemia or bronchodilators, possible HTN dye to hypoxaemia or systemic
inflammatory response
Expected disability findings of acute exacerbation of hypoxaemia
possible disorientation or confusion to dye hypoxaemia/hypoxia, reduced level of
consciousness dye to hypercapnia and hypoxaemia, anxiety or fear of dying due to
dyspnoea
expected environment findings of acute exacerbation of copd
elevated EWS due to >RR, HR and <spo2, increased falls risk due to dyspnoea,
dizziness and/or confusion, decreased braden score due to corticosteroids, reduced
mobility and possible oedema, ex/current smoker, COLDSPA or irritants/triggers,
identify allergies or drug reactions
Airway nursing interventions for a pt with copd
ensure correct positioning to open airway and maintain patency
Breathing nursing interventions for a pt with copd
ensure patient is upright to optimise air entry and facilitate gas exchange, encourage
pursed lip breathing to facilitate exhalation of CO2 and reduce dyspnoea, administer
bronchodilators as prescribed for relaxation of smooth muscle in airways to facilitate gas
QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS
What are the two main characteristics of COPD
emphysema and chronic bronchitis
What is emphysema
loss of elasticity allows alveolu to expand with inspiration but reduces its ability to recoil
with exiration. this results in co2 being trapped and increases alveolar pco2
What results due to an increased PCO2
co2 cannot diffuse readily from pulmonary capillaries causing a build up of co2 in
arterial blood and results in hypercapnia. accumulation of damage causes large spaces
to develop which reduces surface area and decreases gas exchange between alveoli
and pulmonary capillaries
Expected airway findings of exacerbation of copd
airway patent but potentially under threat if decreased level of conciousness due to
hypercapnia and hypoxaemia
Expected breathing findings of exacerbation of copd
increased WOB due to hypercapnia, pursed lip breathing, tachypnoeic, sp02 <90% due
to hypoxaemia, upright or tripod position to expand thoracic cavity and maximise air
entry for gas exchange, adventitious sounds - wheeze due to bronchoconstriction,
, possible decreased air entry due to alveolar collapse, resonant percussion due to
hyperinflation
Expected circulation findings of acute exacerbation of COPD
cool pale peripheries and/or cyanosis due to hypoxaemia, CRT >3 seconds due to
peripheral vasoconstriction, possible elevated temperature due to increased metabolic
rate or infection, diaphoresis due to increased WOB or hypercapnia, tachycardia due to
hypoxaemia or bronchodilators, possible HTN dye to hypoxaemia or systemic
inflammatory response
Expected disability findings of acute exacerbation of hypoxaemia
possible disorientation or confusion to dye hypoxaemia/hypoxia, reduced level of
consciousness dye to hypercapnia and hypoxaemia, anxiety or fear of dying due to
dyspnoea
expected environment findings of acute exacerbation of copd
elevated EWS due to >RR, HR and <spo2, increased falls risk due to dyspnoea,
dizziness and/or confusion, decreased braden score due to corticosteroids, reduced
mobility and possible oedema, ex/current smoker, COLDSPA or irritants/triggers,
identify allergies or drug reactions
Airway nursing interventions for a pt with copd
ensure correct positioning to open airway and maintain patency
Breathing nursing interventions for a pt with copd
ensure patient is upright to optimise air entry and facilitate gas exchange, encourage
pursed lip breathing to facilitate exhalation of CO2 and reduce dyspnoea, administer
bronchodilators as prescribed for relaxation of smooth muscle in airways to facilitate gas
