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."
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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Related Questions
Correct Answer is D
Explanation
A. Stating that palliative care is only for clients with a terminal illness is incorrect. Palliative care is designed for clients with serious, chronic, or life-threatening illnesses and focuses on symptom management and quality of life, regardless of prognosis.
B. Limiting palliative care to those with 6 months or less to live is incorrect. This definition applies to hospice care, not palliative care. Palliative care can be provided alongside curative treatments at any stage of illness.
C. Including restriction of nutritional support is incorrect. Palliative care emphasizes comfort and symptom relief, including providing adequate nutrition and hydration as appropriate for the client’s needs and wishes.
D. Enhancing quality of life by promoting comfort is correct. Palliative care aims to relieve symptoms such as pain, nausea, and fatigue while supporting the client’s emotional, psychological, and spiritual well-being.
Correct Answer is B
Explanation
A. Sit on the client's right side. This is not the best approach. If the client has hearing loss in one ear, the nurse should sit on the side of the client’s better ear, not necessarily the right side.
B. Choose a room that is well-lit and free from background noise. This is the correct choice. A well-lit room helps the client read lips or better perceive any non-verbal cues. Reducing background noise ensures the client can focus on hearing or understanding speech without distractions.
C. Exaggerate lip movement while speaking. While some individuals with hearing loss may rely on lip-reading, exaggerating lip movement can make it more difficult to understand. It is more effective to speak clearly without overemphasizing movements.
D. Ask a few questions at a time. This is not the best strategy. It is better to ask one clear, simple question at a time to ensure the client understands, as too many questions at once can overwhelm them.
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