Diagnostic Tests
What bedside test quickly estimates oxygenation, and what is the target range for COPD patients?
Pulse oximetry (SpO₂); target range is 88–92% to prevent CO₂ retention.
What short-acting bronchodilator provides immediate relief from bronchospasm?
Albuterol (SABA).
What breathing technique prevents airway collapse during exhalation?
Pursed-lip breathing.
What is the primary modifiable risk factor for COPD?
Cigarette smoking.
What is the most effective intervention to slow COPD progression?
Smoking cessation.
Which pulmonary function test (PFT) value is used for GOLD classification of COPD severity?
FEV₁ (Forced Expiratory Volume in 1 second)
Which corticosteroid is used during COPD exacerbations, and for how long?
Prednisone, given short-term (5–14 days) to reduce inflammation and speed recovery.
What position maximizes diaphragm function and relieves shortness of breath?
Tripod position (leaning forward on knees or table).
What genetic deficiency increases the risk for early-onset emphysema?
Alpha-1 antitrypsin deficiency.
Which vaccines are recommended for COPD patients?
Influenza, pneumococcal, RSV, and COVID-19 vaccines
What finding on a chest X-ray suggests COPD?
Hyperinflation with flattened diaphragms and increased lung volumes
Name a long-acting anticholinergic used once daily for maintenance therapy.
Tiotropium.
Name two airway clearance techniques used for COPD.
Chest physiotherapy and huff coughing (or devices like Acapella/Aerobika)
Chronic hypoxia causes which hematologic adaptation?
Polycythemia (increased red blood cell production).
What symptoms should a COPD patient report immediately to their provider?
Increased dyspnea, sputum color/amount changes, or worsening fatigue/confusion.
What are the expected ABG values for a stable COPD patient?
Compensated respiratory acidosis: pH ~7.36, PaCO₂ ~56 mmHg, HCO₃⁻ ~31 mEq/L.
Which inhaler combines an inhaled corticosteroid with a long-acting beta agonist?
Combination inhaler such as Symbicort (budesonide/formoterol).
What dietary modification helps reduce CO₂ production in COPD patients?
Low-carbohydrate meals (high-calorie, high-protein, small frequent meals).
What cardiac condition can result from long-term pulmonary hypertension due to COPD?
Cor pulmonale (right-sided heart failure).
Which lab value should be monitored when titrating oxygen therapy?
Arterial blood gases (especially PaCO₂).
What does a pH <7.35, PaCO₂ >70 mmHg, and PaO₂ <60 mmHg indicate in a COPD patient?
Acute respiratory failure (acute exacerbation with severe gas-exchange impairment).
What medications are used if a bacterial cause is suspected during a COPD exacerbation?
Antibiotics (e.g., azithromycin, doxycycline) along with bronchodilators.
What are the three main nursing priorities during a COPD exacerbation?
Airway, Breathing, and Circulation (ABC) — with oxygen and medications as needed.
List two short-term and two long-term complications of prednisone therapy.
Short-term: Mood swings, insomnia, increased blood glucose.
Long-term: Osteoporosis, adrenal suppression, muscle wasting, infection risk.
During an acute exacerbation, what is the correct order of care priorities?
Airway patency (oxygen, bronchodilators, pursed-lip breathing)
Breathing support (monitor ABGs, titrate O₂)
Circulation (monitor for cor pulmonale and perfusion