Question

Which client is exhibiting signs of advanced chronic obstructive pulmonary disease (COPD)?

1) The client who is sitting in a chair, respirations shallow, 2+ pitting ankle edema present.
2) The client who is reclining in semi-Fowler's position, talking on phone, taking breaths in mid-sentence.
3) The client who is sitting in bed resting elbows on overbed table, expiratory wheezes noted.
4) The client who is walking in hall with pursed lip breathing, pulse oximeter reads 90

Answer 1

The client sitting in bed with expiratory wheezes and using an overbed table to aid breathing is exhibiting signs of advanced COPD.

Step-by-step explanation:

The client exhibiting signs of advanced chronic obstructive pulmonary disease (COPD) is the one described as sitting in bed, resting elbows on an overbed table, with expiratory wheezes noted (option 3). The use of an overbed table to prop themselves up (tripod position) suggests difficulty in breathing, which is characteristic of advanced COPD. Expiratory wheezes indicate an obstruction in the airflow due to narrowed airways, which is common in COPD due to inflammation, mucous, and the breakdown of the alveoli. The reduced elasticity of the alveoli hinders full exhalation and leads to trapped air in the lungs, making gas exchange inefficient and exacerbating shortness of breath.