Which client is at the greatest risk for respiratory complications following general anesthesia?

Smoking is a significant factor that impacts respiratory function and increases the risk of various complications following general anesthesia. Individuals who smoke regularly can experience impaired lung function, reduced mucociliary clearance, and increased secretions, all of which can heighten the risk for respiratory complications such as atelectasis, pneumonia, and bronchospasm after surgery.

In a patient who smokes two packs of cigarettes daily, as in the scenario presented, these risks are compounded due to the chronic exposure to harmful substances that damage the respiratory system over time. This can lead to decreased oxygenation and a higher likelihood of post-operative respiratory issues.

While other factors like asthma, age, hypertension, and obesity can also influence a patient's risk for respiratory complications, the profound effects of heavy smoking on lung health and recovery from anesthesia place the individual who smokes at the greatest risk.