When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

Perform the drainage immediately after meals.

Explain that the client may be placed in five positions.

C. Instruct the client to breathe shallow and fast.

Answer and Explanation

The Correct Answer is B

B. Postural drainage involves placing the client in various positions to help drain secretions from different lobes of the lungs. There are typically five standard positions: head-down, head-up, on the side with the affected lung uppermost, on the side with the affected lung lowermost, and lying prone.

A. Performing postural drainage immediately after meals is not recommended because it can increase the risk of vomiting or aspiration, especially in individuals with chronic obstructive pulmonary disease (COPD) who may already have compromised lung function.

C. In postural drainage, the client is typically instructed to breathe deeply and slowly to maximize the effectiveness of the technique.

D. While ABGs may be necessary for monitoring respiratory status in clients with COPD, they are not specifically required prior to performing postural drainage.

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Correct Answer is B

Explanation

B. Aspiration can lead to serious respiratory complications such as pneumonia. Since the client reports difficulty swallowing (dysphagia) and has a high pain level, addressing the risk for aspiration is crucial to prevent further complications.

A. While nutrition is essential for overall health, it may not be the priority in this case given the severity of other symptoms such as pain, dysphagia, and anxiety.

C. Esophageal cancer can cause significant pain due to tissue destruction by the tumor, which can affect the client's quality of life and ability to function. This however, should be addressed after immediate concerns in the ABCs.

D. While addressing the client's emotional needs is important for holistic care, it may not be the immediate priority compared to managing symptoms such as pain and dysphagia,

A. Determine client's last dose of corticosteroids. B. Administer a PRN IV antiemetic as prescribed. C. Determine neurological baseline prior to the fall. D. Complete head-to-toe neurological assessment.

Correct Answer is D

Explanation

D. The priority nursing intervention should be to assess and stabilize the patient's immediate medical needs. The confusion and vomiting could be indicative of increased intracranial pressure or another acute condition requiring immediate attention. Therefore, the most appropriate first action would be to complete a head-to-toe neurological assessment.

A. Determining the last dose of corticosteroids may not address the immediate concerns of confusion and projectile vomiting.

B. Administering an antiemetic is not the priority action as the vomiting is likely due to head trauma with subsequent raised ICP.

C. Understanding the baseline neurological status is essential for subsequent assessment and management but it may not address the immediate concerns of confusion and vomiting.

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When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

Nursing Test Bank

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