Apatient's history, physical exam, and pulmonary function testing have culminated in a diagnosis of chronic obstructive bronchitis. the nurse who is providing care for this patient will understand that the effects of the disease are primarily attributable to: a. a reduction in oxygen binding sites on erythrocytes
b. decreased respiratory drive
c. autoimmune of alveoli
d. chronic mucus hypersecretion

The correct option is D.

Explanation:

The chronic obstructive bronchitis is characterized by irreversible and persistent flow obstruction, followed by bronchial inflammation, in response to harmful particles or gases (biomass) exposure. There is an increase in the secretory glands and cells in the submucosa, which causes chronic mucus hypersecretion, which leads to the overproduction of mucus and the production of a particularly thick mucus, aggravated by a bad and inefficient ciliary cleaning function and a cough not treated properly, it weakens the respiratory muscles. The damage in chronic bronchitis is due to excess mucus production, with mucoiciliary dysfunction, secondary to persistent bronchial inflammation. The main responsible for this excessive mucus are the overproduction of secretion originated in the cells and the decrease in the elimination of said mucus.

i think that it is c, d, and e, hope this