A nurse is reviewing the laboratory results of a client who is postoperative and has a respiratory rate of 7/min. The arterial blood gas (ABG) values include: pH 7.22 PaCO2 68 mm Hg Base excess -2 PaO2 78 mm Hg Oxygen saturation 80% Bicarbonate 28 mEq/L. Which of the following interpretations of the ABG values should the nurse make?

A. Rest in a supine position.

This option is not recommended for improving gas exchange in emphysema. Resting in a supine position can lead to decreased lung expansion and increased dyspnea in individuals with emphysema. Optimal lung expansion is crucial for efficient gas exchange, and certain positions, such as sitting upright or using pillows to support the head and chest, are preferred to facilitate breathing.

B. Consume a low-protein diet.

A low-protein diet is not directly related to improving gas exchange in emphysema. In fact, adequate protein intake is important for maintaining overall health and supporting respiratory muscle function. Protein is necessary for tissue repair and maintaining muscle strength, including the respiratory muscles. Therefore, a balanced diet that includes adequate protein intake is recommended for individuals with emphysema.

C. Breathe in through her nose and out through pursed lips.

This is the correct choice. Breathing in through the nose and out through pursed lips helps to create positive pressure in the airways during exhalation. This positive pressure helps to keep the airways open, prevents premature collapse of the air sacs (alveoli), and facilitates more effective gas exchange. It also slows down the rate of breathing, reduces the work of breathing, and can alleviate shortness of breath (dyspnea) in individuals with emphysema.

D. Limit fluid intake throughout the day.

Limiting fluid intake throughout the day is not recommended for improving gas exchange in emphysema. Adequate hydration is important for thinning respiratory secretions, which can make it easier to clear mucus from the airways. Dehydration can worsen respiratory symptoms and increase the risk of complications. Therefore, maintaining adequate fluid intake is essential for individuals with emphysema.

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.