A home health care nurse is teaching a client about managing COPD. Which of the following client statements should the nurse identify as an understanding of the teaching?

"I'll use pursed-lip breathing when I feel short of breath."

"I'll skip my exercises for the week if I feel short of breath."

"I will use my inhaler 30 minutes after each meal."

"I will limit myself to drinking only 1 quart of water each day."

Answer and Explanation

The Correct Answer is A

A) "I'll use pursed-lip breathing when I feel short of breath.": Pursed-lip breathing is a beneficial technique for clients with COPD as it helps keep the airways open longer, reduces the work of breathing, and improves ventilation. This statement indicates the client understands a key management strategy for COPD.

B) "I'll skip my exercises for the week if I feel short of breath.": Regular exercise is important for managing COPD, and while adjustments may be necessary when symptoms are severe, completely skipping exercise can lead to deconditioning and worsening of symptoms. This statement does not reflect appropriate management of COPD.

C) "I will use my inhaler 30 minutes after each meal.": Inhalers should be used as prescribed, usually before activities that might trigger symptoms, such as eating, rather than on a fixed schedule unrelated to symptoms or physician's guidance. This statement indicates a misunderstanding of inhaler use.

D) "I will limit myself to drinking only 1 quart of water each day.": Staying hydrated is important for thinning mucus in COPD. Unless there are specific medical reasons to restrict fluids, such as heart failure, limiting water intake could lead to dehydration and thickened mucus, making breathing more difficult. This statement is not appropriate for managing COPD.

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Correct Answer is B

Explanation

A) "Switch from breastfeeding to formula feeding when your baby is 2 months old": Breastfeeding is associated with a reduced risk of otitis media, as breast milk contains antibodies and other factors that help protect against infections. Switching to formula feeding may not reduce the incidence of otitis media and can potentially increase the risk.

B) "Avoid exposing your baby to secondhand smoke": Exposure to secondhand smoke is a significant risk factor for otitis media. Smoke irritates the respiratory tract and can lead to inflammation and fluid accumulation in the middle ear, increasing the likelihood of ear infections. Avoiding secondhand smoke can help reduce the incidence of otitis media.

C) "Ensure your baby receives the Hepatitis B vaccine": While the Hepatitis B vaccine is important for preventing Hepatitis B infection, it does not have a direct impact on the incidence of otitis media. The vaccine’s primary role is in preventing liver disease rather than ear infections.

D) "Place your baby in a supine position during feeding": Placing a baby in a supine position (lying on their back) during feeding does not reduce the risk of otitis media. In fact, feeding a baby while lying flat can increase the risk of ear infections as it may cause milk to flow into the middle ear. It is generally recommended to hold the baby in an upright or semi-upright position during feeding.

A. Maintain the client on bed rest for 48 hr following surgery. B. Check the tubing for kinks and blood clots at least every 2 hr. C. Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate. D. Remove the catheter if the client reports severe bladder spasms.

Correct Answer is B

Explanation

A) Maintain the client on bed rest for 48 hr following surgery: While some bed rest is recommended initially post-surgery, maintaining bed rest for 48 hours is excessive and can increase the risk of complications like deep vein thrombosis. Early mobilization is generally encouraged to enhance recovery.

B) Check the tubing for kinks and blood clots at least every 2 hr: Regularly checking the catheter tubing for kinks and blood clots is essential to ensure the continuous flow of urine and prevent catheter blockage. This can help in reducing the risk of complications such as bladder distension and urinary retention.

C) Irrigate the client's bladder continuously using 5% dextrose in Ringer's lactate: Continuous bladder irrigation is often done post-TURP to prevent clot formation, but 5% dextrose in Ringer's lactate is not the recommended solution. Typically, normal saline is used to minimize the risk of electrolyte imbalance and maintain the correct osmolarity.

D) Remove the catheter if the client reports severe bladder spasms: Severe bladder spasms can occur post-TURP, but removing the catheter is not the immediate solution. The catheter is necessary for drainage and should be managed with antispasmodic medications or adjusting the irrigation flow rather than removal.

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