A nurse is caring for a client who is scheduled for a procedure. Which of the following actions should the nurse take during the time-out?
(Select All that Apply.)

A. Pursed-lip breathing does not require a specific body position, but it is often more comfortable and effective when the patient is in a semi-Fowler’s position (elevated head of the bed) or sitting upright. Being flat on the back might actually make breathing more difficult for some patients with COPD.
B. The technique involves inhaling slowly through the nose and exhaling through pursed lips, which creates a slight resistance during expiration. This helps to keep the airways open longer, reduce airway collapse, and improve oxygen exchange. Proper inhalation and exhalation technique are key components of effective pursed-lip breathing.
C. In pursed-lip breathing, expiration should be longer than inspiration. The recommended pattern is to inhale slowly through the nose for about 2 counts and then exhale slowly through pursed lips for about 4 counts. The extended expiration phase helps to remove trapped air from the lungs and improves overall ventilation.
D. Coughing forcefully is not a part of pursed-lip breathing. Pursed-lip breathing focuses on controlled breathing to improve airflow and ease breathing. Coughing can be done separately if needed, but it is not a component of the pursed-lip breathing technique.

A. 0.9% sodium chloride, also known as Normal Saline, is an isotonic solution. It has the same concentration of solutes as blood plasma, which means it does not change the cell's fluid volume but rather maintains it. It is not considered hypotonic.

B. 0.45% sodium chloride, commonly known as Half Normal Saline, is a hypotonic solution. It has a lower concentration of sodium chloride compared to the normal saline and is used to provide hydration and to help correct electrolyte imbalances by allowing water to move into the cells.
C. Dextrose 5% in Lactated Ringer's is not a hypotonic solution. It is actually a type of hypertonic solution. Initially, dextrose 5% is isotonic, but once the dextrose is metabolized, the solution becomes hypotonic due to the electrolyte content of Lactated Ringer’s. However, the classification is generally based on the solution before metabolism, and it is not commonly used as a hypotonic solution.
D. Lactated Ringer's solution is an isotonic solution. It contains electrolytes in concentrations similar to those found in the body's plasma, and it is used to restore fluids and electrolytes. It does not have a hypotonic effect on cells.