A nurse is caring for a client with a medical diagnosis of acute exacerbation of chronic obstructive pulmonary disease (COPD). The client's assessment reveals a respiratory rate of 28/min, SpO2 at 90%, and complaints of mild dyspnea and anxiety at rest. What should the nurse include in the client's discharge teaching plan?
Use bronchodilators every 2 hours as needed.
Instructions on pursed-lip breathing.
Increase home oxygen from 3L/min to 5L/min as needed.
Use huff coughing to loosen secretions.
The Correct Answer is B
Choice A reason:
Using bronchodilators every 2 hours as needed may not be appropriate for all clients. Bronchodilators are typically used on a schedule or as needed based on symptoms, but overuse can lead to tolerance and decreased effectiveness. The nurse should provide education on the proper use and timing of bronchodilators.
Choice B reason:
Pursed-lip breathing is a technique that helps control shortness of breath and improve ventilation. It can slow down the client's breathing, promote relaxation, and ensure more effective lung function. This technique is particularly beneficial during an acute exacerbation of COPD and should be included in the discharge teaching plan.
Choice C reason:
Increasing home oxygen without proper assessment can be dangerous. Oxygen therapy should be titrated based on the client's oxygen saturation and clinical status. Clients with COPD are at risk of CO2 retention, and too much oxygen can suppress their drive to breathe. The nurse should educate the client on monitoring their SpO2 and when to adjust oxygen levels, typically under the guidance of a healthcare provider.
Choice D reason:
Huff coughing is a technique used to clear mucus from the airways. While it can be effective, it should be taught by a respiratory therapist or nurse who can assess the client's ability to perform the technique correctly. It is not the first-line teaching for a client being discharged with an acute exacerbation of COPD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason
While coronary artery spasm can cause chest pain, it is not the typical cause of unstable angina. Unstable angina is generally due to atherosclerotic heart disease, where plaque buildup in the coronary arteries restricts blood flow. This statement does not fully reflect an understanding of the condition.
Choice B Reason
Beta blockers are often prescribed to manage angina as they reduce the heart's workload and oxygen demand. However, they do not always prevent angina pain, especially in the case of unstable angina, which can occur unpredictably and not just during exertion. This statement shows partial understanding but lacks the urgency associated with unstable angina.
Choice C Reason
Seeking immediate medical attention when experiencing angina pain is crucial, especially in the case of unstable angina, which can signal an impending heart attack. This statement indicates that the client understands the seriousness of their condition and the need for prompt action.
Choice D Reason
While rest can help alleviate stable angina pain, unstable angina is less predictable and may not be relieved by rest. This type of angina requires medical evaluation to prevent more serious complications, such as myocardial infarction. This statement does not convey an adequate understanding of the condition.
Correct Answer is ["A","B","C"]
Explanation
Choice A Reason
Monitoring blood glucose levels before exercise is crucial for individuals with Type 2 diabetes. Exercise can lower blood glucose levels, and it's important to ensure they are not too low before starting, which could lead to hypoglycemia during physical activity. The patient should be taught how to check their glucose and understand their target ranges.
Choice B Reason
Recognizing the signs and symptoms of hypoglycemia is essential for all individuals with diabetes, especially those on medications that can lower blood glucose levels. Symptoms may include shakiness, sweating, confusion, and in severe cases, loss of consciousness. Patients should know how to respond to these symptoms promptly.
Choice C Reason
Weight control through diet and exercise is a fundamental part of managing Type 2 diabetes. A BMI of 28 falls into the overweight category, and reducing weight can help improve insulin sensitivity and blood glucose control. The patient should receive guidance on healthy eating and physical activity tailored to their needs.
Choice D Reason
Decreasing fiber and protein in the diet is not recommended for individuals with Type 2 diabetes. In fact, a diet high in fiber can help control blood sugar levels, and adequate protein intake is important for overall health. Patients should be encouraged to consume a balanced diet with sufficient fiber and protein.
Choice E Reason
While regular eye examinations are important for individuals with diabetes, obtaining them every 3 months is not typically necessary unless there is an existing eye condition that requires close monitoring. Generally, an annual eye exam is recommended to check for diabetes-related eye complications.
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