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Rasmussen Nursing II Exam 2 Questions & 100% Correct Answers

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COPD :~~ Limited Airflow (due to thick and swollen bronchioles that have become deformed with excessive sputum production and this narrows the airways) Inability to fully exhale (due to loss of elasticity of the alveoli sacs from damage and the sacs start to develop air pockets) Irreversibl...

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rasmussen nursing ii exam 2 questions 100 corre
copd limited airflow due to thick and swoll

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Rasmussen Nursing II Exam 2
Questions & 100% Correct Answers-
COPD

✓ :~~ Limited Airflow (due to thick and swollen bronchioles that have become

deformed with excessive sputum production and this narrows the airways)

Inability to fully exhale (due to loss of elasticity of the alveoli sacs from damage

and the sacs start to develop air pockets)

Irreversible once developed...cases vary among people from mild to

severe...managed with lifestyle changes and medications.

Happens gradually....most people start to notice signs and symptoms middle-aged

and will present with dyspnea with activity they could normally tolerate, recurrent

lung infections, chronic cough etc.

COPD is a term used as a "catch all" for diseases that limit airflow and cause

dyspnea.

Types of COPD

✓ :~~ Emphysema "pink puffers"

Master01 | September, 2024 | Latest Update

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Chronic bronchitis "blue bloaters"

"Blue bloaters"

✓ :~~ The name "blue bloaters" is due to cyanosis from "hypoxia" and bloating

from edema AND increase in lung volume. The bloating is from the effects of

the lung disease on the heart which causes right-sided heart failure. Also,

less oxygen is getting into the blood and more carbon dioxide is staying in

the blood.

This leads to low blood levels and high carbon dioxide levels. Patients will have

cyanosis due to a decreased oxygen level. To compensate, the body increases RBC

production and cause blood to shift elsewhere which increases pressure in the

pulmonary artery leading to pulmonary hypertension. Pulmonary hypertension

leads to right-sided heart failure (which is why you will start to see

bloating..edema in the abdomen and legs)

"Pink puffers"

✓ :~~ The name "pink puffers" comes from hyperventilation (puffing to

breathe) and pink complexion (they maintain a relatively normal oxygen

level due to rapid breathing) rather than cyanosis as in chronic bronchitis.

In emphysema, the alveolar sacs lose their ability to inflate and deflate due to an

inflammatory response in the body. So, the sac is unable to properly deflate and

Master01 | September, 2024 | Latest Update

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inflate. Inhaled air starts to get trapped in the sacs and this causes major

hyperinflation of the lungs because the patient is retaining so much volume.

Hyperinflation causes the diaphragm to flatten. The diaphragm plays a huge role in

helping the patient breathe effortlessly in and out. Therefore, in order to fully

exhale, the patient starts to hyperventilate and use accessory muscles to get the

air out now. This leads to the barrel chest look and during inspect it may be noted

there is an INCREASED ANTEROPOSTERIOR DIAMETER.

The damage in the sacs cause the body to keep high carbon dioxide levels and low

blood oxygen levels. Inhaled oxygen will not be able to enter into the sacs for gas

exchange and carbon dioxide won't leave the cells to be exhaled.

The body tries to compensate by causing hyperventilation (increasing the

respiratory rate...hence puffer) and the patient will have less hypoxemia "pink

complexion" than chronic bronchitis who have the cyanosis because pink puffers

keep their oxygen level just where it needs to be from hyperventilation.

COPD what not to do?

✓ :~~ Oxygen must be administered with caution!

The amount shouldn't exceed 3L/minute because many people with COPD retain

too much CO2

Master01 | September, 2024 | Latest Update

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Too high of a level of O2 could suppress the person's respiratory drive (loses the

natural stimulus to breathe). So the low O2 becomes the stimulus for respiration

instead of the elevated CO2.

Be careful of narcotics because they cause respiratory depression!

COPD nursing diagnoses

✓ :~~ Impaired gas exchange related to airflow obstruction from collapsed

alveoli and narrow bronchioles

Anxiety related to breathlessness, ineffective coping, and reduced socialization

Ineffective breathing pattern related to increased mucous production and air

trapping

Activity intolerance related to fatigue and hypoxemia

Nutrition imbalance, less than body requirements, related to increased energy

expenditure from breathing difficulties

COPD nursing interventions

Master01 | September, 2024 | Latest Update

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