A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

"You should inhale through your nose and exhale through your mouth during purse-lipped breathing."

"Your inspiration should be longer than expiration during purse-lipped breathing."

"You should cough forcefully during exhalation when you are purse-lipped breathing."

"You should be flat on your back when you perform purse-lipped breathing."

Answer and Explanation

The Correct Answer is A

A. "You should inhale through your nose and exhale through your mouth during purse-lipped breathing."

Pursed-lip breathing is a breathing technique commonly used by individuals with COPD to help improve breathing efficiency and manage dyspnea (shortness of breath). During purse-lip breathing, the individual inhales slowly through the nose and exhales slowly and gently through pursed lips, creating a slight resistance to the airflow. This technique helps to keep the airways open longer during exhalation, reduces air trapping, and improves oxygenation.

B. "Your inspiration should be longer than expiration during purse-lipped breathing."

Pursed-lip breathing typically involves making both the inspiration and expiration longer than usual. The focus is on slowing down the breathing rate and extending the exhalation phase to promote better gas exchange and reduce respiratory effort.

C. "You should cough forcefully during exhalation when you are purse-lipped breathing."

Pursed-lip breathing is a gentle breathing technique used to promote relaxation and control of breathing. Forceful coughing during exhalation is not part of purse-lip breathing and may not be appropriate, especially for individuals with COPD who are prone to airway irritation and bronchospasm.

D. "You should be flat on your back when you perform purse-lipped breathing."

The position for performing purse-lip breathing is not specific to lying flat on the back. Individuals can perform purse-lip breathing in various positions that are comfortable and allow for effective breathing, such as sitting upright or leaning slightly forward. The key is to find a position that facilitates relaxation and optimal lung expansion.

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Correct Answer is A

Explanation

A. Liver function tests

This is the correct choice. Pyrazinamide, a medication used in the treatment of tuberculosis, is known to potentially cause hepatotoxicity, which refers to liver damage or dysfunction. Therefore, clients prescribed pyrazinamide should undergo regular monitoring of liver function tests to assess for any signs of liver injury or impairment. Liver function tests typically include measurements of various enzymes and proteins produced by the liver, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and bilirubin levels.

B. Gallbladder studies

Gallbladder studies are not typically indicated for clients taking pyrazinamide. While pyrazinamide can rarely cause hepatotoxicity, which may affect liver function, it is not known to specifically target or affect the gallbladder. Therefore, routine gallbladder studies are not necessary for clients taking pyrazinamide.

C. Thyroid function studies

Pyrazinamide is not known to directly affect thyroid function. Therefore, routine thyroid function studies are not indicated for clients taking pyrazinamide unless there are specific signs or symptoms suggesting thyroid dysfunction.

D. Blood glucose levels

Pyrazinamide is not known to directly affect blood glucose levels. Therefore, routine monitoring of blood glucose levels is not indicated for clients taking pyrazinamide unless there are specific reasons to suspect or monitor for diabetes mellitus or other conditions affecting blood glucose regulation.

A. Position the client on the nonoperative side. B. Monitor respiratory status every 8 hr. C. Elevate the head of the bed to a 15° angle. D. Encourage the client to splint the incision when coughing.

Correct Answer is D

Explanation

A. Position the client on the nonoperative side.

Positioning the client on the nonoperative side after a pneumonectomy may not be the best choice. The positioning of the client post-pneumonectomy should be based on factors such as the individual's comfort, respiratory status, and any specific instructions from the healthcare provider. Placing the client on the nonoperative side may inadvertently put pressure on the surgical site, leading to discomfort or potential complications.

B. Monitor respiratory status every 8 hr.

Monitoring respiratory status every 8 hours is not sufficient for a client post-pneumonectomy. After such a major surgical procedure, respiratory status should be closely monitored and assessed more frequently, especially in the immediate postoperative period. This frequency allows for the early detection of any signs of respiratory distress, such as decreased oxygen saturation, dyspnea, or abnormal breath sounds, as well as complications like pneumothorax or atelectasis.

C. Elevate the head of the bed to a 15° angle.

Elevating the head of the bed to a 15° angle is a general recommendation for clients postoperative to promote respiratory function and reduce the risk of aspiration. However, after a pneumonectomy, the positioning of the client may vary based on their individual condition and surgical approach. It's important to follow the healthcare provider's specific instructions regarding positioning for optimal recovery. The angle of elevation may need to be adjusted based on the client's comfort and respiratory status.

D. Encourage the client to splint the incision when coughing.

After a pneumonectomy, it's crucial to encourage the client to splint the incision when coughing. Splinting the incision with a pillow or hands helps to reduce pain and prevent strain on the surgical site, promoting healing and minimizing the risk of complications such as wound dehiscence (opening of the surgical incision).

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A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

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Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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