A patient with chronic obstructive pulmonary disease (COPD) asks the nurse why clubbing occurs. Which response by the nurse is most therapeutic?
a. "Your disease doesn't send enough oxygen to your fingers."
b. "Your disease affects both your lungs and your heart, and not enough blood is being pumped."
c. "Your disease will be helped if you pursed-lip breathe."
d. "Your disease often makes patients lose mental status."
ANS: A
Clubbing of the nail bed can occur with COPD and other diseases that cause prolonged oxygen deficiency or chronic hypoxemia. Pursed-lipped breathing helps the alveoli stay open but is not the cause of clubbing. Loss of mental status is not a normal finding with COPD and will not result in clubbing. Low oxygen and not low circulating blood volume is the problem in COPD that results in clubbing.
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