A nurse is planning care for a client who has COPD with dyspneic episodes. Which of the following interventions should the nurse include?

Instruct the client to perform coughing exercises after meals.

Limit the client's fluid intake to 1,500 mL/day.

Encourage the client to sit in a chair for 1 hr several times per day.

Initiate oxygen therapy for the client via nasal cannula at 10 L/min.

Answer and Explanation

The Correct Answer is A

A) Instruct the client to perform coughing exercises after meals.
Coughing exercises after meals can help clear the airways of mucus, which is beneficial for clients with COPD. Effective airway clearance is crucial to improve breathing and reduce the risk of infections. This intervention can enhance respiratory function and comfort.

B) Limit the client's fluid intake to 1,500 mL/day.
Limiting fluid intake is generally not recommended for clients with COPD unless there is a specific medical reason, such as heart failure. Adequate hydration helps keep mucus thin and easier to expectorate, which is important for respiratory health.

C) Encourage the client to sit in a chair for 1 hr several times per day.
Encouraging the client to sit in a chair helps promote mobility and prevent complications associated with prolonged bed rest. However, while sitting up can improve lung expansion, it is not the most specific or direct intervention to address dyspneic episodes.

D) Initiate oxygen therapy for the client via nasal cannula at 10 L/min.
Administering oxygen at a high flow rate like 10 L/min is not typically appropriate for clients with COPD due to the risk of depressing their respiratory drive. Oxygen therapy should be carefully titrated and monitored based on the client's needs and blood gas levels.

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Correct Answer is D

Explanation

A) "Drink whole milk instead of skim milk": Whole milk contains higher levels of saturated fats compared to skim milk. For individuals with hyperlipidemia, it is advisable to reduce intake of saturated fats to help lower cholesterol levels and improve heart health. Drinking skim or low-fat milk is a healthier option to manage lipid levels.

B) "Limit saturated fat to 15 percent of total daily fat intake": The American Heart Association recommends that saturated fat intake should be limited to less than 7% of total daily calories for those managing hyperlipidemia. Limiting saturated fat to 15% is too high and can contribute to increased cholesterol levels, negatively impacting cardiovascular health.

C) "Select trans fats for daily fat intake": Trans fats are known to significantly raise LDL (bad) cholesterol levels and lower HDL (good) cholesterol, increasing the risk of heart disease. It is essential to avoid trans fats altogether in the diet, as they are detrimental to cardiovascular health.

D) "Replace red meat with fish three times per week": Replacing red meat with fish, especially fatty fish like salmon, mackerel, and sardines, can be beneficial for individuals with hyperlipidemia. Fish is a good source of omega-3 fatty acids, which can help lower triglyceride levels, reduce inflammation, and improve overall heart health. This dietary change supports better lipid management and reduces the risk of cardiovascular diseases.

A. "After chewing an antacid, wait 1 hour before drinking water." B. "Plan to have a bedtime snack each evening." C. "Elevate the head of your bed 12 inches." D. "Eat a sugar-free peppermint when symptoms occur."

Correct Answer is C

Explanation

A) "After chewing an antacid, wait 1 hour before drinking water.": This is incorrect advice as drinking water after taking an antacid can help wash the medication down and ensure it reaches the stomach effectively. Waiting an hour to drink water is unnecessary and does not benefit GERD management.

B) "Plan to have a bedtime snack each evening.": Having a bedtime snack can exacerbate GERD symptoms by increasing stomach acid production just before lying down. Clients with GERD should avoid eating close to bedtime to minimize symptoms.

C) "Elevate the head of your bed 12 inches.": Elevating the head of the bed helps prevent stomach acid from flowing back into the esophagus during sleep, which can reduce nighttime GERD symptoms. This is a recommended non-pharmacological intervention for managing GERD.

D) "Eat a sugar-free peppermint when symptoms occur.": Peppermint can relax the lower esophageal sphincter, potentially worsening GERD symptoms by allowing stomach acid to reflux into the esophagus. Therefore, peppermint is not recommended for managing GERD symptoms.

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A nurse is planning care for a client who has COPD with dyspneic episodes. Which of the following interventions should the nurse include?

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