A nurse is making judgments about problem status for a client with depression who has been receiving psychotherapy and antidepressant medication for 6 weeks. Which of the following statements should the nurse make?

Choice A reason:

The client has achieved partial resolution of the problem. This statement is not accurate because it implies that the client's problem is no longer present or significant, which is not the case for COPD. COPD is a chronic and progressive disease that causes irreversible lung damage and airflow limitation. The client may have improved symptoms or reduced exacerbations, but the problem is still present and requires ongoing management.

Choice B reason:

The client has met all the goals and no longer needs nursing care. This statement is not correct because it suggests that the client has fully recovered from COPD, which is not possible. COPD is a lifelong condition that cannot be cured, only managed. The client will always need nursing care to monitor their condition, prevent complications, educate them on self-care, and provide emotional support.

Choice C reason:

The client has not made any progress and requires a different approach. This statement is not valid because it indicates that the client has failed to respond to the current plan of care, which may not be true. COPD is a variable disease that can have periods of stability and exacerbation. The client may have made some progress in achieving their goals, such as improving their gas exchange, airway clearance, breathing pattern, activity tolerance, or quality of life. A different approach may not be necessary unless the client's condition worsens or does not improve despite optimal treatment.

Choice D reason:

The client has shown improvement but needs more time to reach the goals. This statement is the best one to make because it reflects the realistic and positive outcome of the evaluation for a client with COPD. COPD is a complex and chronic disease that requires long-term and individualized care. The client may have shown improvement in some aspects of their condition, such as reducing their dyspnea, cough, or sputum production, increasing their oxygen saturation, or enhancing their exercise capacity. However, they may still need more time to reach their full potential or maintain their progress. The nurse should acknowledge the client's improvement but also encourage them to continue with their plan of care and follow-up. I hope this answer helps you with your question. If you need more information on COPD or nursing care plans, you can check out these.

Choice A reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's weight loss may be due to increased diuretic therapy, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's weight has decreased by 2 kg since discharge as a result of the nurse's education on diuretic therapy and daily weight monitoring.".

Choice B reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's dyspnea may be due to noncompliance with fluid restriction, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's dyspnea has worsened despite the nurse's education on fluid restriction and sodium intake.".

Choice C reason:

This statement is incorrect because it does not relate an outcome to an intervention. The client's edema may have improved due to elevation of the lower extremities, but it is not clear how this is an outcome of the nurse's actions. A better statement would be: "The client's edema has improved as a result of the nurse's instruction on elevating the lower extremities and wearing compression stockings.".

Choice D reason:

This statement is correct because it relates an outcome to an intervention. The client's fatigue may have decreased due to participation in a cardiac rehabilitation program, which is an intervention that the nurse can facilitate or recommend for a client with heart failure. This statement shows that the nurse is evaluating the effectiveness of the intervention and the client's progress.