Medical-Surgical Nursing – COPD – Academic Year – Study Notes

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Which diagnostic test will the clinic nurse anticipate to confirm a diagnosis of
chronic obstructive pulmonary disease (COPD) in a patient with dyspnea?

Spirometry

Chest x-ray

Arterial blood gas (ABG)

CT scan of the chest


Spirometry

Spirometry is needed to confirm the presence of airflow obstruction and the
severity of COPD. The patient is given a short-acting bronchodilator, and post-
bronchodilator values are compared with a normal reference value. Chest x-
rays are not diagnostic but can show a flat diaphragm caused by hyperinflated
lungs. ABGs are used to determine gas exchange but are not diagnostic of
COPD because many diseases can impact ABG results. CT scans are not
used routinely to diagnose COPD.


Which factor causes the clinical manifestations of chronic obstructive
pulmonary disease (COPD)?

Decrease in respiratory drive

Inability to effectively expire air

Enhanced elastic recoil of airways

Diminished inflammatory response


Inability to effectively expire air

In COPD, changes in the airways lead to loss of elastic recoil, airflow
obstruction during expiration, and ineffective expiration. Respiratory drive is not
decreased in COPD. Elastic recoil of the airways is decreased, leading to
hyperinflation of the alveoli and loss of lung elasticity. Increased inflammatory
response to noxious gases, such as tobacco smoke, leads to chronic
inflammatory airway changes that are characteristic of COPD.


Cachexia


weakness and wasting of the body due to severe illness