You are evaluating and assessing a patient with a diagnosis of chronic emphysema. The patient is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?
1. Fine bibasilar crackles
2. Respiratory rate of 8 breaths/min
3. The patient sitting up and leaning over the nightstand
4. A large barrel chest
2. You are evaluating and assessing a patient with a diagnosis of chronic emphysema. The patient is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which finding concerns you immediately?
1. Fine bibasilar crackles
2. Respiratory rate of 8 breaths/min
3. The patient sitting up and leaning over the nightstand
4. A large barrel chest
Ans: 2. Respiratory rate of 8 breaths/min
For patients with chronic emphysema, the stimulus to breathe is a low serum oxygen level (the normal stimulus is a high carbon dioxide level). This patient's oxygen flow is too high and is causing a high serum oxygen level, which results in a decreased respiratory rate. If you do not intervene, the patient is at risk for respiratory arrest. Crackles, barrel chest, and assumption of a sitting position leaning over the nightstand are common in patients with chronic emphysema. Focus: Prioritization