11. In reviewing the laboratory and x-ray reports of an elderly client, which findings should a nurse identify as being consistent with a diagnosis of emphysema?
11. In reviewing the laboratory and x-ray reports of an elderly client, which findings should a nurse identify as being consistent with a diagnosis of emphysema?
. Increased PCO2, hypoinflated alveoli, and decreased PO2.
. Decreased PCO2, decreased PO2, and decreased hematocrit.
. Increased PCO2, hyperinflated alveoli, and decreased hematocrit.
. Increased PCO2, increased hematocrit, and hyperinflated alveoli.
Test-Taking Tip
Review the physiological changes with emphysema—trapped air, poor gas exchange, production of immature RBCs to carry O2.
Content Area: Geriatrics, Respiratory; Integrated Process: Nursing Process, Analysis; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Pathophysiology
.
Answer 1 is incorrect because alveoli are hyper-inflated, trapping air. Answer 2 is incorrect because CO2 increases. Hypoxemia causes the body to increase red blood cell (RBC) production and hematocrit (Hct) increases. Answer 3 is incorrect because hematocrit will be increased in response to hypoxemia. Answer 4 is correct because emphysema is an obstructive pulmonary disease that traps air in the alveoli. The gas exchange is impaired as CO2 increases. The body attempts to improve oxygenation by producing more red blood cells. There are immature RBCs that result in a more sluggish circulation.