A patient with a history of COPD Is being monitored for potential complications. Which of the following findings should the nurse report immediately as it may indicate the development of a complication?
Mild wheezing
Fatigue and general malaise
Increased sputum production
Sudden onset chest pain and dyspnea
The Correct Answer is D
A. Mild wheezing: Mild wheezing can be a common symptom in COPD and does not immediately indicate a severe complication unless it worsens suddenly.
B. Fatigue and general malaise: Fatigue and malaise are often chronic in COPD and do not necessarily indicate an acute complication.
C. Increased sputum production: While increased sputum could suggest an infection, it is not the most urgent sign of a severe complication.
D. Sudden onset chest pain and dyspnea: Sudden chest pain and dyspnea are concerning for a pneumothorax or pulmonary embolism, both of which are potential complications in COPD and require immediate attention.
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Correct Answer is D
Explanation
A. Pulmonary Function Test (PFT). PFTs assess lung function but do not provide diagnostic information for infections like pneumonia.
B. Electrocardiogram (ECG). An ECG assesses heart function and would not help in diagnosing a respiratory infection like pneumonia.
C. Complete Blood Count (CBC). A CBC may indicate infection through elevated white blood cells, but it does not confirm pneumonia or identify its location in the lungs.
D. Chest X-ray. A chest X-ray is the most useful diagnostic tool to confirm pneumonia. It can reveal infiltrates or consolidation in the lungs, which are characteristic of pneumonia.
Correct Answer is C
Explanation
A. Administering pain medication: Pain management is essential, but in this case, the primary concern is potential airway compromise due to inhalation injury, which should be addressed first.
B. Applying a cool, wet cloth to burned areas: Cooling burned areas can help with pain and reduce burn severity but is not the priority in a case of suspected inhalation injury with airway compromise.
C. Administering high-flow oxygen via a non-rebreather mask: This client is at high risk for respiratory compromise due to inhalation injury; administering high-flow oxygen is the priority to ensure adequate oxygenation.
D. Initiating intravenous fluid resuscitation: Fluid resuscitation is essential for burn patients but is not the immediate priority over addressing potential airway and oxygenation issues.