A nurse is planning care for a patient with emphysema. Which of the following is a primary focus?

A. Optimizing gas exchange: Emphysema involves the irreversible destruction of alveolar walls and permanent enlargement of air spaces, which severely impairs the surface area for gas exchange. The primary goal of care is to maximize the patient's ability to oxygenate tissues and remove carbon dioxide. This addresses the core pathophysiological defect of the disease. B. Managing acute infections: While emphysema patients are prone to secondary infections, the primary chronic focus is on respiratory mechanics and gas exchange. Infection management is a periodic necessity rather than the defining daily goal of care for emphysema. The plan of care focuses on long-term pulmonary rehabilitation. C. Controlling chest pain: Chest pain is not a hallmark symptom of emphysema; rather, patients experience dyspnea and air hunger. If chest pain occurs, it may indicate a complication like a spontaneous pneumothorax or myocardial ischemia. It is not the primary focus of standard emphysema management. D. Reducing fluid overload: Fluid overload is more characteristic of right-sided heart failure (cor pulmonale) or renal failure. While emphysema can lead to heart failure, the initial and primary focus remains on the lung parenchyma and gas exchange. Fluid management is a secondary concern related to potential cardiovascular complications.