A patient with chronic obstructive pulmonary disease (COPD) on daily prednisone therapy has been eating very little and has lost weight. Which interventions are appropriate for the nurse to include in the care plan? Select all that apply.
Offer high-calorie protein snacks between meals and at bedtime.
Encourage increased intake of whole grains and vegetables.
Encourage rest before meals.
Provide a large glass of juice with each meal.
Correct Answer : A,C
Choice A reason: Offering high-calorie protein snacks between meals and at bedtime is appropriate for a patient with COPD who is losing weight and eating very little. These snacks can help meet their nutritional needs and provide the extra calories and protein necessary to prevent muscle wasting and support overall health.
Choice B reason: While increasing the intake of whole grains and vegetables is generally healthy, it may not be the priority for a patient who has lost significant weight and needs to focus on higher-calorie, nutrient-dense foods. The primary goal is to address the calorie and protein deficit first.
Choice C reason: Encouraging rest before meals is beneficial as it helps conserve energy for eating. Patients with COPD often experience fatigue, which can reduce their appetite and ability to eat. Resting before meals can help them feel more energetic and better able to consume their meals.
Choice D reason: Providing a large glass of juice with each meal is not ideal for increasing calorie and protein intake. While juice can provide some calories and nutrients, it is not a good source of protein. Additionally, large volumes of liquid can create a feeling of fullness, reducing the patient's appetite for nutrient-dense foods.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A hemoglobin level of 12.0 g/dL is slightly below the normal range for men but is not the most critical concern preoperatively. It indicates mild anemia, which should be monitored but does not present an immediate high risk.
Choice B reason: A serum creatinine level of 1.3 mg/dL is slightly elevated and indicates mild renal impairment. While this should be considered, it is not as immediately concerning as a significantly abnormal coagulation value.
Choice C reason: A Blood Urea Nitrogen (BUN) level of 24 mg/dL is slightly above normal, indicating some renal function impairment or dehydration. However, it does not pose the most significant immediate risk compared to a high INR value.
Choice D reason: An INR of 3.5 is significantly elevated and indicates a high risk of bleeding. For a surgical patient, this is the most concerning pre-op lab value because it suggests that the patient's blood is not clotting properly. This increases the risk of excessive bleeding during and after surgery, making it a priority to address before proceeding with the operation.
Correct Answer is C
Explanation
Choice A reason: NPH (Humulin N) is an intermediate-acting insulin that is used to control blood sugar levels throughout the day, not specifically for mealtime coverage. It is typically administered twice a day.
Choice B reason: Detemir (Levemir) is a long-acting insulin that provides basal insulin coverage. It helps maintain blood sugar levels stable over a 24-hour period and is not intended for controlling post-meal blood sugar spikes.
Choice C reason: Lispro (Humalog) is a rapid-acting insulin used for mealtime coverage. It is designed to be taken just before or immediately after a meal to control the sudden rise in blood sugar levels that occurs after eating.
Choice D reason: Glargine (Lantus) is a long-acting insulin that provides basal insulin coverage, helping to maintain steady blood glucose levels throughout the day and night. It is not used for mealtime blood sugar control.
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