A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.)

A. 24-year-old woman with allergic rhinitis:

Likely safe to take an alpha-adrenergic decongestant as allergic rhinitis is a common indication for decongestant use in young, healthy individuals.

B. 18-year-old man with cold symptoms:

Likely safe to take an alpha-adrenergic decongestant as it's a common indication for decongestant use in young, healthy individuals.

C. 64-year-old woman with a history of heart disease:

Should avoid alpha-adrenergic decongestants due to the risk of increasing blood pressure and potentially worsening heart conditions.

D. 70-year-old woman with glaucoma:

Should avoid alpha-adrenergic decongestants due to the risk of exacerbating glaucoma by causing pupil dilation and increasing intraocular pressure.

E. 56-year-old man with prostatic hypertrophy:

Should avoid alpha-adrenergic decongestants due to the risk of worsening urinary symptoms caused by prostatic hypertrophy, such as urinary retention.

A. Start slowly and increase volume over several sessions.

This is the correct choice. For clients having difficulty using an incentive spirometer, starting slowly and gradually increasing the volume over several sessions is an appropriate approach. It allows the client to become familiar with the device and the technique required for effective use. Starting slowly also reduces the risk of discomfort or respiratory distress, allowing the client to build up their lung capacity gradually and achieve optimal results over time.

B. Do regular deep-breathing exercises instead.

Regular deep-breathing exercises are beneficial for improving lung function and respiratory strength. However, using an incentive spirometer serves a specific purpose in promoting deep breathing and lung expansion to prevent atelectasis (lung collapse) and improve respiratory function. While deep-breathing exercises are helpful, they may not provide the same targeted benefits as using an incentive spirometer, especially for clients who are experiencing difficulty with deep breathing or lung expansion.

C. Use another device because this one might be faulty.

This option assumes that the difficulty with the incentive spirometer is due to a fault in the device itself, which may not necessarily be the case. Before considering another device, it's important to ensure that the client is using the current device correctly and receiving proper instruction. If the client continues to have difficulty despite proper technique and instruction, then further assessment of the device may be warranted.

D. Be much more vigorous in increasing increments.

Being much more vigorous in increasing increments is not recommended, as it could lead to discomfort, respiratory distress, or hyperventilation for the client. Increasing the volume too quickly may overwhelm the client and make it more difficult for them to use the incentive spirometer effectively. Gradual progression allows the client to adjust to the device and build up their lung capacity safely and effectively over time.