A client is admitted with long-standing chronic obstructive pulmonary disease (COPD)and is at risk for respiratory failure.Every 4 hours, the nurse performs a focused respiratory assessment.Which assessment action will the nurse include during each reassessment? Select all that apply. A)Neck vein distention B)Color of nail beds C)Presence of sternal retractions D)Temperature of extremities E)SpO₂

Question

Quizplus · Accepted Answer

The nurse should assess the color of nail beds to check for cyanosis, presence of sternal retractions as an indicator of respiratory distress, and SpO2 to monitor oxygen saturation levels, all of which are relevant to respiratory status in a COPD patient.

A Client Is Admitted with Long-Standing Chronic Obstructive Pulmonary Disease