The nurse caring for a morbidly obese client who is recovering from abdominal surgery recogniz-es that this client is at risk for respiratory complications specifically caused by: (Select all that ap-ply.)

Question

1. Poor muscle tone, resulting in decreased respiratory muscle function
2. Increased risk for infection, resulting in increased oxygen requirements
3. Deceased lung volume resulting from compression of abdominal organs
4. Increased presence of pulmonary secretions in the lower lobes bilaterally
5. Obesity-hypoventilation syndrome resulting from chronic carbon dioxide reten-tion
6. Pain resulting in reluctance to deep breathe and facilitate exchange of oxygen and carbon dioxide

Answer 1

ANS: 1, 2, 3, 4, 5
Morbidly obese clients have a reduction in compliance as a result of encroachment of the abdo-men into the chest, increased work of breathing, and decreased lung volumes. In some clients an obesity-hypoventilation syndrome develops in which oxygenation is decreased and carbon diox-ide is retained. The obese client is also susceptible to pneumonia after surgery or an upper respir-atory tract infection because the lungs do not fully expand and the lower lobes retain pulmonary secretions. Pain is a universal barrier to effective breathing; it is not unique to the obese client.