A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

"Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals."

"Drink at least 240 milliliters of water during each meal."

"Perform pulmonary hygiene 1 hour before meals."

"Lie down for 30 minutes after eating."

Answer and Explanation

The Correct Answer is C

A. "Self-administer oxygen through your nasal cannula at 6 milliliters per minute during meals." is incorrect. Oxygen should not typically be increased during meals unless specifically prescribed by the provider. If the client has difficulty eating due to breathlessness, a more individualized plan is needed.

B. "Drink at least 240 milliliters of water during each meal." is incorrect. Clients with COPD may have difficulty breathing when consuming large amounts of fluids during meals. Overhydration could also worsen fluid retention in some cases. The amount of fluid should be tailored to the client’s needs and prescribed by the healthcare provider.

C. "Perform pulmonary hygiene 1 hour before meals." is correct. Pulmonary hygiene (such as postural drainage, coughing techniques, and deep breathing exercises) should be performed before meals to clear the airways and improve the ability to breathe while eating, preventing aspiration and difficulty breathing.

D. "Lie down for 30 minutes after eating." is incorrect. Lying down after eating can increase the risk of aspiration, especially in clients with COPD who may already have a compromised respiratory system. The client should be advised to remain upright after meals to prevent reflux and aspiration.

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Correct Answer is B

Explanation

A. Removing personal protective equipment (PPE. after leaving the room is incorrect because it should always be done before leaving the client's room to ensure the nurse does not accidentally spread the infection. Proper removal of PPE is crucial to preventing transmission.

B. Wearing a gown when assisting the client with personal hygiene is correct. MRSA is typically spread through direct contact, so wearing a gown when providing personal care (e.g., assisting with hygiene. helps prevent the spread of MRSA. Additionally, gloves and other PPE should also be worn.

C. Negative air pressure is typically required for airborne precautions, such as for clients with tuberculosis, but not for MRSA, which is transmitted via contact. Therefore, this is not necessary for MRSA care.

D. Restricting the client's visitors is not necessary unless the client has an infection that requires isolation precautions beyond what is standard for MRSA. MRSA can be controlled with contact precautions, and visitor restrictions are generally not part of standard MRSA isolation.

A. A client who has a sodium intake of 1,200 mg/day. B. A client who has a serum albumin level of 4.5 g/dL. C. A client who has a body mass index of 32. D. A client who has a total fat intake of 25% of daily calories.

Correct Answer is C

Explanation

A. A client who has a sodium intake of 1,200 mg/day.: A sodium intake of 1,200 mg/day is actually within the recommended range for most adults. Therefore, this client does not require a dietitian’s consultation based on this information alone.

B. A client who has a serum albumin level of 4.5 g/dL.: A serum albumin level of 4.5 g/dL is within the normal reference range. There is no immediate concern with this level, so an interprofessional care conference is not necessary for this client.

C. A client who has a body mass index of 32.: A BMI of 32 is classified as obese, which can increase the risk of various health problems. A dietitian’s input can help address dietary modifications to manage weight and improve health outcomes, making an interprofessional care conference appropriate.

D. A client who has a total fat intake of 25% of daily calories.: A fat intake of 25% is within the acceptable range for most adults and does not immediately warrant a referral to a dietitian unless there are other concerns.

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A nurse is reinforcing discharge teaching with a client who has COPD and reports problems with maintaining adequate nutrition. Which of the following instructions should the nurse include?

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