A nurse is developing a plan of care for a client who has COPD.
The nurse should include which of the following interventions in the plan?

Choice A rationale

Quadriplegia, or tetraplegia, involves paralysis affecting all four limbs and the torso, typically occurring with spinal cord injuries at the cervical level (C1-C8). A T2-T3 injury is below the cervical spine, so it would not result in quadriplegia.

Choice B rationale

Paraplegia involves paralysis that affects the lower half of the body, including both legs, and typically results from spinal cord injuries at the thoracic (T1-T12) or lumbar (L1-L5) levels. A T2-T3 injury would spare upper limb function but impair sensation and movement in the trunk and lower extremities.

Choice C rationale

Paresthesia refers to abnormal sensations such as tingling, prickling, or numbness, without actual paralysis. While paresthesia can be present with a spinal cord injury, it describes a sensory disturbance, not the type of motor disability, which is the primary focus of this question.

Choice D rationale

Hemiplegia is paralysis affecting one side of the body and is typically associated with brain injuries like stroke, rather than spinal cord injuries. Spinal cord injuries generally cause bilateral deficits below the level of the lesion.

Choice A rationale

Increasing oxygen flow without assessing the client's respiratory status first can be detrimental for a client with COPD. High oxygen concentrations can suppress the hypoxic drive, which is a primary stimulus for breathing in some COPD patients, potentially leading to hypoventilation and respiratory acidosis.

Choice B rationale

While coughing and expectorating secretions can improve airway clearance, it is not the initial priority when a client with COPD reports difficulty breathing. A comprehensive assessment is crucial to determine the underlying cause of dyspnea before implementing interventions that may not be appropriate.

Choice C rationale

Calling emergency services immediately without first assessing the client's respiratory status is premature. The nurse needs to gather more information to determine the severity of the client's condition and whether immediate emergency intervention is warranted, or if other actions can alleviate the distress.

Choice D rationale

Assessing the client's respiratory status is the priority action. This involves evaluating respiratory rate, depth, effort, use of accessory muscles, oxygen saturation (SpO2), and breath sounds. This provides objective data to guide further interventions and determine the severity of the respiratory distress.