112 COPD

Determine which is correctly paired with its symptoms.

• Chronic Bronchitis - collapsed alveoli & mucous production

• Chronic Bronchitis - Inflammation & dyspnea

• Emphysema - Collapsed alveoli & impaired air flow

• Emphysema - Cough & collapsed aveoli

Answer explanation

Chronic bronchitis cause inflammation leading to production of more mucus, causing chronic COUGH

Emphysema is a destruction of alveoli which leads to decreased surface area during exhalation, impairing air flow in lungs, leading to DYSPNEA. (Overtime, may become overinflated)

Which of the following is true about Alpha Antitrypsin (AAT) Deficiency?

• It is the number 1 leading cause of COPD

• It can cause lung and liver disease

• Its most prevalent in Hispanic Americans who smoke

• It stems from irritants, dust, and smoke at the workplace

Answer explanation

Smoking is the #1 leading cause of COPD and COPD is most prevalent in hispanic americans who smoke.

Air pollution can cause COPD by irritants, dust, and smoke at the workplace

AAT Deficiency is a genetic disorder made in the liver & secreted to bloodstream to help protect lungs from inflammation.

True or False: The only risk factors for COPD are smoking and irritant exposures.

• True

• False

Answer explanation

Asthma is also a risk factor for COPD.

Smoking, irritant exposure, and asthma are risk factors for COPD.

Which symptoms indicate the patient is having dyspnea? (Select all that apply)

• Accessory muscle use when breathing

• Purse lip breathing

• Orthopnic position

• Fatigue

Answer explanation

Fatigue indicates lack of O2 delivery.

Whistling sounds indicate narrowed arway.

Coughing & rattling in the chest indicate inflammation of bronchi and having rales (coarse crackles) in the lungs.

True or false: When smoker's cough starts as dry but becomes productive, could be an early sign of COPD.

• True

• False

Answer explanation

Some long-term smokers develop a chronic cough “smoker’s cough” that can start off dry but change to productive.  Caused by chemical irritation of the lung tissue.  This change could be the first sign of COPD so need to be assessed frequently by their health care provider. 

A patient with a barrel chest indicates which of the following? (Select all that apply)

• Patient is in the early stage of COPD

• Lungs are hyperinflated

• Heart sounds are better heard over the xiphoid process

• The patient is having difficulty exhaling O2

• Will always have diminished breath sounds

Answer explanation

Barrel chest indicate late stage COPD

Patient is having difficulty exhaling CO2, not O2.

Breath sounds can be subjective, diminished sounds may be from thick chest walls, obese, large breasts, or severe PNA

Why do COPD patients lose weight? (Select all that apply)

• Decreased activity tolerance to prepare food

• Mental challenges about condition that decreased appetite

• Increased caloric demand as effort to breathe increases

• Small space between lungs & stomach

What does the Schamroth's sign indicate?

• Clubbing of nails

• Unaltered nails

Answer explanation

Absent Scharmroth's sign indicate clubbing of nails.

What are COPD patients more likely to acquire? (Select all that apply)

• Respiratory infections

• Pulmonary Hypertension

• Cor. pulmonale

• Anxiety

• Depression

What would diagnostic tests show in a patient with COPD? (Select all that apply)

• Increased amount of secretions in lungs & alveolar sacs

• Decreased levels of hemoglobin

• Increased CO2

• Decreased ventilation with normal perfusion

• Decreased residual air volume

Answer explanation

CXR will show increased amount of secretions in lungs & alveolar sacs

CBC w/ diff show inc. Hgb to compensate for low O2

ABG shows inc. CO2 due to trouble with exhaling CO2

PFT measures lung volume & air flow; pt will have INCREASED residual air volume.

VQ scan would have shown dec. ventilation with normal perfusion