A client with rheumatoid arthritis (RA) is scheduled for a joint replacement surgery. The nurse should teach the client to discontinue which medication before the surgery to prevent bleeding complications?

Pursed-lip breathing is a technique that helps to slow down the breathing rate, reduce air trapping, and improve gas exchange in clients with COPD. It also helps to relieve dyspnea and anxiety.

Incorrect options:

B) Administer oxygen via nasal cannula at 6 L/min. - This is an incorrect intervention, as clients with COPD are at risk of developing oxygen-induced hypercapnia, a condition where high levels of oxygen reduce the drive to breathe and cause carbon dioxide retention. Oxygen therapy should be administered cautiously and titrated to maintain a target oxygen saturation of 88-92% in clients with COPD.

C) Position the client in a supine position with the head elevated. - This is an incorrect intervention, as a supine position can increase the pressure on the diaphragm and impair lung expansion, worsening dyspnea and hypoxemia in clients with COPD. A semi-Fowler's or high-Fowler's position is preferred, as it allows for maximal lung expansion and reduces the work of breathing.

D) Instruct the client to cough forcefully every hour. - This is an incorrect intervention, as forceful coughing can increase airway resistance, cause bronchospasm, and increase dyspnea in clients with COPD. A more effective coughing technique is to use huff coughing, which involves exhaling forcefully through an open mouth while making a "huff" sound.

Disequilibrium syndrome is a neurological complication of hemodialysis that occurs when the rate of solute removal from the blood exceeds the rate of solute removal from the brain, creating an osmotic gradient that causes fluid to shift into the brain cells, resulting in cerebral edema. Symptoms of disequilibrium syndrome include headache, nausea, vomiting, restlessness, confusion, and seizures. It usually occurs during or shortly after the first few dialysis sessions or when there is a large decrease in blood urea nitrogen (BUN) levels.

Incorrect options:

A) Hyperkalemia - This is an incorrect option, as hyperkalemia is a common complication of CKD that occurs when the kidneys are unable to excrete excess potassium. Hemodialysis helps to lower potassium levels by removing it from the blood. However, hyperkalemia may occur between dialysis sessions if the client consumes foods high in potassium or takes medications that increase potassium levels, such as angiotensin-converting enzyme (ACE) inhibitors or potassium-sparing diuretics.

B) Hypertension - This is an incorrect option, as hypertension is a common complication of CKD that occurs when the kidneys are unable to regulate fluid and sodium balance. Hemodialysis helps to lower blood pressure by removing excess fluid and sodium from the blood. However, hypertension may occur between dialysis sessions if the client consumes foods high in sodium or fluid or takes medications that increase blood pressure, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.

C) Hypocalcemia - This is an incorrect option, as hypocalcemia is a common complication of CKD that occurs when the kidneys are unable to activate vitamin D and promote calcium absorption from the gut. Hemodialysis helps to correct hypocalcemia by adding calcium to the dialysate solution. However, hypocalcemia may occur between dialysis sessions if the client consumes foods low in calcium or takes medications that lower calcium levels, such as phosphate binders or bisphosphonates.