A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which finding would indicate a potential complication of the disease?

The client with MS should plan activities that require more energy for the morning, when they are likely to have more strength and endurance. Fatigue and muscle weakness tend to worsen as the day progresses, especially in warm or humid weather. The client should also prioritize and pace their activities, and take rest breaks as needed.

Incorrect options:

A) Performing exercises that target the affected muscles - This is not a helpful strategy, as overexertion of the affected muscles can aggravate fatigue and weakness. The client should perform exercises that are moderate, low-impact, and well-tolerated, such as stretching, yoga, or swimming.

C) Taking frequent naps throughout the day - This is not a helpful strategy, as frequent naps can disrupt the sleep cycle and interfere with nighttime sleep quality. The client should aim for seven to eight hours of uninterrupted sleep at night, and limit naps to 20 to 30 minutes in the afternoon if needed.

D) Increasing fluid and caffeine intake - This is not a helpful strategy, as excessive fluid intake can cause bladder problems, such as urgency, frequency, or incontinence, which are common in clients with MS. Caffeine intake can also worsen these symptoms, as well as cause dehydration, insomnia, or anxiety.

The client should be advised to avoid drinking alcohol while taking methotrexate, as this can increase the risk of hepatotoxicity and liver damage. Methotrexate is metabolized by the liver and can cause elevated liver enzymes and inflammation. The client should also have regular liver function tests while taking this medication.

Incorrect options:

A) "You should take this medication with food or milk to prevent stomach upset." - This is not a correct statement, as methotrexate should be taken on an empty stomach, at least one hour before or two hours after meals, to enhance absorption and effectiveness.

C) "You should monitor your blood pressure regularly while taking this medication." - This is not a relevant statement, as methotrexate does not affect blood pressure. However, the client should monitor their blood counts regularly while taking this medication, as methotrexate can cause bone marrow suppression and anemia.

D) "You should take this medication every day for optimal results." - This is not a correct statement, as methotrexate is usually taken once a week for RA. Taking it more frequently can increase the risk of adverse effects and toxicity.