When admitting an older client with chronic obstructive lung disease (COPD), which finding most concerns the nurse?
1. Chronic cough with thick sputum
2. Calluses on both of the client's elbows
3. Lives with child and grandchildren
4. Use of fire place for winter heat
4. Use of fire place for winter heat
Explanation: 1. Chronic cough with tenacious or thick clear sputum is typical in the client with COPD. Mucolytics and increased fluid intake helps to thin secretions.
2. Older clients with COPD often have calluses on their elbows as a result of leaning over tables to stretch out their torsos so that more air can enter and exit during respiration. It is often referred to as the "tripod" position.
3. As long as everyone in the house observes infection control measures such as hand washing, covering their face for coughs and sneezes, and obtaining vaccinations, living with the family is usually a positive finding.
4. The client with COPD is likely on oxygen and should not be near an open flame. Wood stoves and smoky fires create indoor pollutants that are dangerous for the client with COPD.
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