The nurse is performing a respiratory assessment on a patient. Which assessment findings indicate to the nurse that the patient has a history of long-standing chronic respiratory disease? (Select all that apply.)
a. All of the patient's fingernails are noticeably clubbed.
b. The patient needs to sleep on at least four to five pillows at night.
c. The patient's chest has equal antero-posterior and transverse diameters.
d. The patient's lower legs have large areas of brownish spotted discoloration.
e. The patient reports puffiness of both feet when standing for long periods.
f.
The patient's forced vital capacity test result is 3.8 L of air.
ANS: A, B, C
Clubbing of fingernails, the need to sleep in an upright position, and a barrel chest are all indicative of long-standing chronic respiratory disease like COPD. Brownish spotted discoloration is indicative of venous insufficiency. Forced vital capacity of almost 4 L is found in patients with good respiratory function.
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