In COPD patients, secondary complications can arise due to?

PGIMER Sangrur NO - 2023

Medical & Surgical Nursing

Hard

Appeared in: PGIMER Sangrur NO - 2023

Explanation

Chronic Obstructive Pulmonary Disease (COPD) leads to chronic hypoxia (low blood oxygen levels).
In response to hypoxia, the kidneys increase the production of erythropoietin (EPO).
EPO stimulates the bone marrow to produce an excess of red blood cells, a condition called secondary polycythemia.
This increase in red blood cells makes the blood more viscous (thicker), which slows blood flow and increases the risk of clot formation (thrombosis).
COPD is listed as a medical condition that predisposes patients to venous thromboembolism (VTE).

Option B: The hyperviscosity and inflammatory state associated with COPD create a hypercoagulable (pro-clotting) environment, making thrombosis the primary risk, not bleeding.
Option C: Thrombocytopenia is a low platelet count. The chronic inflammation in COPD can sometimes lead to a reactive thrombocytosis (an increased platelet count), which is the opposite of thrombocytopenia.
Option D: Neutropenia is a low count of neutrophils. COPD exacerbations are frequently caused by bacterial infections, which trigger an immune response that increases neutrophil production (neutrophilia) to fight the infection.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiological Complications of COPD as background academic context rather than a clinical decision trigger.
Nurses must monitor the complete blood count (CBC) of patients with severe COPD, paying close attention to hemoglobin and hematocrit levels to identify secondary polycythemia.
Recognizing the heightened risk for venous thromboembolism (VTE) is critical. Nurses should perform regular assessments for signs of DVT (e.g., calf pain, swelling, warmth) and PE (e.g., sudden dyspnea, chest pain).
Patient education should include the importance of hydration (to reduce blood viscosity) and mobility (to prevent stasis), which are key non-pharmacological interventions to reduce thrombosis risk.

How to Approach the Question

First, identify the core pathology of the disease mentioned in the stem: COPD is characterized by chronic hypoxia.
Next, consider the body's long-term compensatory mechanisms for this core problem. How does the body try to adapt to low oxygen?
Recall or deduce the physiological chain of events: Hypoxia stimulates erythropoietin (EPO) from the kidneys.
Connect EPO's function to the blood: EPO increases red blood cell (RBC) production.
Analyze the consequence of too many RBCs: This leads to polycythemia, which increases blood viscosity (thickness).
Finally, link thick, slow-moving blood to the options provided. Hyperviscosity directly increases the risk of clot formation, or thrombosis.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 pp. 150-152, 152-154

E6 Medicine Davidson Principles Practice 24e p. 995-997