A nurse is caring for a client who has COPD. The nurse should identify that which of the following findings is the priority to report?
A.
Hgb 20 g/dL
B.
Oxygen saturation 92%
C.
Productive cough with green sputum
D.
Chest x-ray shows hyperinflation of lungs
The priority finding to report for a client with COPD is:
A. Hgb 20 g/dL
Explanation:
- A. Hgb 20 g/dL: A hemoglobin (Hgb) level of 20 g/dL is significantly elevated. This could indicate polycythemia, which is a condition where there is an increased number of red blood cells. In patients with COPD, this can be a response to chronic hypoxia. Elevated hemoglobin can increase the risk of complications like thrombosis and indicates that the patient might be experiencing chronic hypoxia. This finding should be reported immediately for further evaluation and intervention.
- B. Oxygen saturation 92%: While oxygen saturation of 92% is below the normal range (typically 95-100% for healthy individuals), it is not as immediately concerning as a significantly elevated hemoglobin level. COPD patients can often have lower oxygen saturation, so this level should be monitored but does not represent an acute or critical finding on its own.
- C. Productive cough with green sputum: A productive cough with green sputum can indicate an infection, but it is a common symptom in COPD and does not usually require urgent reporting unless accompanied by other serious symptoms or changes in the patient’s condition.
- D. Chest x-ray shows hyperinflation of lungs: Hyperinflation of the lungs is a common finding in COPD and is usually a chronic issue rather than an acute concern. This finding is consistent with the disease process and is not typically an urgent issue unless there are significant changes or worsening symptoms.
Thus, A. Hgb 20 g/dL is the priority finding to report due to its potential implications and the need for further investigation and management.