1. Have a good understanding of hypoxia and clinical manifestations.What would you see in the patient? (479t): Answer -Hypoxia: Inadequate oxygenation. Due to obstruction. -CNS: (EARLY) Unexplained apprehension, unexplained restlessness or irritability, unexplained confusion or lethargy, (LATE) unexplained confusion or lethargy, combativeness, coma. -Respiratory: (EARLY) Tachypnea, dyspnea on exertion, (LATE) dyspnea at rest, use of accessory muscles, retraction of intercostal spaces on inspiration, pause for breath between sentences, words. -Cardiovascular:(EARLY) Tachycardia, mild hypertension, dysrhythmias, (LATE) dysrythmias, hypotension, cyanosis, cool/clammy skin. -Other: (EARLY and LATE) Diaphoresis, decreased urine output, unexplained fatigue. 2. If you are a patient with chronic hypoxemia combined with polycythemia vera, what will your skin look like? Blood capacity for carrying O2 is de- creased.: Answer -Blue and red/flushed skin. -Know colors to be able to detect it when you see it. -Breathing capacity? Accessory muscle use, pursed lip, barrel chest. -What kind of posture? Tripod. 3. Goals of patient with COPD? Manage s/s of the disease and being able to maintain function: Answer -Goals: (596) 1. Prevention of disease progression 2. Ability to perform ADLs and improved exercise tolerance 3. Relief from symptoms 4. No complications related to COPD 5. Knowledge and ability to implement a long-term treatment regimen 6. Overall improved quality of life -Signs and Symptoms: Clinical manifestations typically develop slowly, but COPD should be considered in all patients over age 40 with 10 or more pack years of cigarette smoking. A diagnosis of COPD should be considered in any patient who hassymptoms of cough,sputumproduction, or dyspnea and/or a history of exposure to risk factors for the