A patient with chronic obstructive pulmonary disease (COPD) is hospitalized for heart failure. The patient is weak and cannot cough, so the nurse should watch closely for the development of


•Atelectasis refers to the collapse of alveoli. Often it causes no problems, but enough atelectasis can decrease the lungs' ability to diffuse oxygen and carbon dioxide.

•Without the removal of secretions, atelectasis can form mucus plugs and cause airway obstruction.

•Risk for pneumonia can increase when secretions are not cleared, but atelectasis is more likely to develop first.

•Pulmonary hypertension and pleural effusions are not caused by secretion build up.

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