Medical Surgical COPD #5

Question

A nurse caring for a client with chronic obstructive pulmonary disease (COPD) auscultates wheezes and diminished breath sounds. The wheezes and diminished breath sounds indicate that the client is experiencing which complication of COPD?

Answers

  1. The client is experiencing hypersaturation in oxygen.
    • Rationale:

      This answer is not correct because the opposite is true and the client is experiencing a bronchospasm and hypoxemia as a result. The client would display a low oxygen saturation during bronchospasm.

  2. The client is experiencing pulmonary emboli.
    • Rationale:

      This answer is not correct because pulmonary emboli is not considered a complication of COPD. Signs and symptoms of pulmonary embolism include hypoxemia, restlessness, and air hunger. Wheezes are not characteristic of a pulmonary embolism.

  3. The client is experiencing a bronchospasm.
    • Rationale:

      This answer is correct because a bronchospasm and diminished breath sounds are characteristic of inflammation of large airways that cause narrowing and subsequent wheezing sounds on auscultation. Bronchospasm and subsequent bronchoconstriction occurs frequently in clients with COPD and asthma.

  4. The client has the complication of pneumonia.
    • Rationale:

      This answer is not correct because infections and pneumonia may occur in clients with COPD; however, auscultation may also reveal crackles, rales due to fluid movement, and a possible friction rub. Wheezing and diminished breath sounds are more closely associated with bronchospasms and bronchoconstriction in clients with COPD.

Overview

The focus of this question is the bronchospasm and bronchoconstriction experienced in clients with COPD. Bronchospasm is manifested as the sound of wheezes on auscultation and breath sounds may also be diminished as a result of very little movement of air in and out of the lungs.

Explanation

Learning Outcomes

Wheezes are a high pitched, musical sound mainly heard during exhalation but can also be heard upon inspiration. Wheezes are most commonly heard in clients with asthma but are also fairly common in clients with COPD. The sound produced when wheezes are auscultated is caused by narrowing of the airway during bronchospasm or bronchoconstriction.

Test Taking Tip

The key to answering this question is an understanding of typical manifestations of COPD. Understanding the pathophysiology of COPD is key to the correct identification of bronchospasms and bronchoconstriction as expected findings in this disease process. This will help you differentiate between possible correct answers such as pneumonia, which can also cause diminished breath sounds.

Video Rationale