A nurse is caring for a client who has COPD. Which of the following actions should the nurse take?
Encourage the client to drink 8 glasses of water a day.
Instruct the client to cough every 4 hr.
Provide the client with a low protein diet.
Advise the client to lie down after eating.
The Correct Answer is A
A. Encourage the client to drink 8 glasses of water a day.
This is the correct choice. Clients with COPD often have thickened respiratory secretions due to chronic inflammation and mucus production. Adequate hydration helps to keep these secretions thin, making them easier to cough up and clear from the airways. Encouraging the client to drink plenty of fluids, such as water, can assist in maintaining optimal hydration levels and promoting effective airway clearance.
B. Instruct the client to cough every 4 hours.
Instructing the client to cough on a scheduled basis, such as every 4 hours, is not appropriate for managing COPD. While coughing is important for clearing respiratory secretions, the frequency of coughing should be based on the client's individual needs and symptoms. Some clients with COPD may need to cough more frequently, while others may need to cough less often. It's important to encourage the client to cough as needed to clear secretions rather than on a predetermined schedule.
C. Provide the client with a low-protein diet.
Providing the client with a low-protein diet is not recommended for managing COPD. Adequate protein intake is important for maintaining muscle strength, including respiratory muscles, and supporting overall health. Clients with COPD may have increased energy needs due to the increased work of breathing and should be encouraged to consume a balanced diet that includes adequate protein.
D. Advise the client to lie down after eating.
Advising the client to lie down after eating is not recommended for managing COPD. Lying down after eating can increase pressure on the diaphragm and make breathing more difficult, especially for individuals with compromised lung function. It's generally recommended for individuals with COPD to remain in an upright position after eating to minimize respiratory discomfort and reduce the risk of aspiration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Lower oxygen saturations of 93% to 94%
In an older adult client with a pneumothorax, the nurse could expect to observe lower oxygen saturations of 93% to 94%. A pneumothorax involves the accumulation of air in the pleural space, which can compress the lung and impair gas exchange, leading to hypoxemia (low blood oxygen levels). Decreased oxygen saturations would be a common finding in this condition.
B. Higher oxygen saturations of 98% to 99%
Higher oxygen saturations would be less likely in a client with a pneumothorax due to impaired gas exchange resulting from lung compression. Oxygen saturations are more likely to be lower in this condition, as indicated in option A.
C. Lower energy expenditure
While a pneumothorax may cause discomfort and dyspnea, which could potentially decrease energy expenditure due to reduced activity levels, it is not a direct physiological effect of the condition. Energy expenditure would depend on various factors, including the severity of symptoms and the individual's overall health status.
D. Increased lung capacity
A pneumothorax typically results in a decrease in lung capacity rather than an increase. The accumulation of air in the pleural space causes partial or complete collapse of the affected lung, reducing its ability to expand and decreasing overall lung capacity. Therefore, increased lung capacity would not be expected in a client with a pneumothorax.
Correct Answer is B
Explanation
A. Prone with arms raised over the head.
This position involves lying face down with the arms raised over the head. It is not appropriate for thoracentesis because it does not provide easy access to the thoracic cavity, and it may compress the chest, making it difficult for the client to breathe comfortably during the procedure.
B. Sitting, leaning forward over the bedside table.
This is the correct choice. For thoracentesis, the client should be positioned sitting upright and leaning forward over the bedside table or supported by pillows. This position allows better access to the thoracic cavity and facilitates the removal of pleural fluid. Leaning forward also helps to open up the intercostal spaces, making it easier for the healthcare provider to insert the needle into the appropriate space between the ribs.
C. High Fowler's position.
The High Fowler's position involves the client sitting upright with the head of the bed elevated at a 90-degree angle. While this position may be used for other respiratory procedures or for comfort, it is not the optimal position for thoracentesis. It does not provide the same degree of access to the thoracic cavity as the sitting position with forward leaning.
D. Side-lying with knees drawn up to the chest.
This position involves lying on one side with the knees drawn up to the chest. It is not appropriate for thoracentesis because it does not provide access to the thoracic cavity, and it may obstruct the procedure. Additionally, this position may not be comfortable for the client during the procedure.
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