The patient is a 51-year-old male with pneumonia.
The patient has a history of hypertension and takes enalapril and a multivitamin daily.
His surgical history includes adenoid removal at age 4 and a surgical repair of a fractured tibia at age 20. Based on the information that the nurse has about the patient, what condition is he likely to have?

Choice A rationale:

Liquefying secretions is the most crucial action to address the client's immediate respiratory concerns. Thickened mucus obstructs airflow, leading to shortness of breath, productive cough, and difficulty breathing upon exertion. Increasing fluid intake thins mucus, making it easier to expel and improving ventilation. This directly addresses the client's current symptoms and promotes airway clearance.

Hydration and Mucociliary Clearance: Adequate hydration is indispensable for optimal mucociliary clearance, the natural mechanism that removes mucus from the airways. Fluids moisten the respiratory tract, allowing cilia (tiny hair-like structures) to effectively move mucus upwards, where it can be coughed out or swallowed.

Thinning Mucus: Water acts as a natural expectorant, thinning mucus and reducing its viscosity. This makes it easier for the client to cough up the mucus, clearing the airways and reducing the sensation of breathlessness.

Decreasing Mucus Production: Dehydration can trigger the body to produce more mucus as a protective response. By staying hydrated, the client can help prevent excessive mucus production, further easing symptoms.

Supporting Overall Respiratory Health: Proper hydration maintains the health of the respiratory system's tissues and cells, promoting efficient gas exchange and reducing inflammation.

Preventing Dehydration-Related Complications: Dehydration can exacerbate respiratory problems and lead to other complications, such as fatigue, headaches, and impaired immune function. Maintaining adequate fluid intake helps prevent these issues.

Key points to emphasize to the client:

Drink fluids throughout the day, even if not feeling thirsty.

Water is the best choice, but clear broths, juices, and herbal teas can also contribute to fluid intake. Avoid caffeine and alcohol, as they can be dehydrating.

Monitor urine output to ensure adequate hydration (urine should be pale yellow or clear).

Increase fluid intake during periods of increased mucus production, such as during respiratory infections or exercise.

Choice A rationale:

Incorrect. Open-angle glaucoma is not characterized by an abnormally small angle.

The angle in open-angle glaucoma is open, but the drainage system is not working properly. Therefore, restoring a smaller angle would not be an effective treatment goal.

Choice B rationale:

Incorrect. Eye drops used to treat open-angle glaucoma are not typically used for pain control.

While some individuals may experience mild discomfort associated with elevated eye pressure, pain is not a common symptom of open-angle glaucoma.

Additionally, eye drops used to treat glaucoma do not have anti-inflammatory properties to address swelling.

Choice C rationale:

Incorrect. While reducing excess eye pressure is an important initial goal of treatment, long-term management of open-angle glaucoma requires ongoing maintenance of normal eye pressure.

Simply reducing pressure temporarily is not sufficient to prevent vision loss.

Choice D rationale:

Correct. The primary goal of treatment for open-angle glaucoma is to maintain normal eye pressure over the long term. This is because elevated eye pressure can damage the optic nerve, leading to vision loss.

Eye drops are often used to lower eye pressure, and they typically need to be used for life to prevent vision loss.