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

Obtain arterial blood gases (ABGs) prior to procedure.

Explain that the patient may be placed in five positions.

Perform the drainage immediately after meals.

Instruct the patient to breathe shallow and fast.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

While ABGs can provide valuable information about a patient's respiratory status, they are not routinely required prior to postural drainage in patients with COPD.

ABGs might be considered if the patient is experiencing acute respiratory distress or if there are concerns about their oxygenation or ventilation status.

However, in the absence of such concerns, obtaining ABGs would not be necessary and could potentially cause discomfort or anxiety for the patient.

Choice C rationale:

Performing postural drainage immediately after meals is not recommended for patients with COPD.

This is because eating can cause a feeling of fullness in the stomach, which can make it difficult for the patient to breathe deeply and effectively during the procedure.

Additionally, there is a risk of aspiration if the patient were to vomit during or after postural drainage.

It is generally recommended to perform postural drainage at least 1-2 hours after meals to reduce these risks.

Choice D rationale:

Instructing the patient to breathe shallow and fast is not appropriate for postural drainage.

The goal of postural drainage is to help the patient mobilize and expectorate secretions from the lungs.

This is best achieved by encouraging the patient to breathe deeply and slowly, which helps to open up the airways and promote mucus clearance.

Shallow, rapid breathing can actually make it more difficult to clear secretions and can lead to increased shortness of breath.

Choice B rationale:

Explaining that the patient may be placed in five positions is the most appropriate approach for postural drainage in a patient with COPD.

This is because different positions help to drain different areas of the lungs. The five positions typically used for postural drainage are:

Head down position (to drain the lower lobes)

Prone position (to drain the posterior segments of the lungs)

Right lateral position (to drain the right middle lobe and right lower lobe) Left lateral position (to drain the left lower lobe)

Sitting upright position (to drain the upper lobes)

By placing the patient in these different positions, the nurse can help to ensure that all areas of the lungs are drained effectively.

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Correct Answer is C

Explanation

Choice A rationale:

It is true that antibiotics are not effective against viruses like influenza. They only work against bacteria.

However, while providing this information to the client is accurate, it does not directly address the client's inquiry about taking oseltamivir, which is an antiviral medication.

It's essential for the nurse to guide the client toward the appropriate healthcare provider who can assess the client's condition and make an informed decision about whether oseltamivir is a suitable treatment option.

Choice B rationale:

While it is true that influenza vaccination is most effective when given before exposure to the virus, it is still a relevant consideration even after symptoms have begun.

Studies have shown that antiviral medications like oseltamivir can potentially reduce the severity and duration of influenza symptoms, even when started within 48 hours of symptom onset.

Therefore, simply advising the client that it's too late for vaccination without exploring other potential treatment options would be incomplete and potentially disadvantageous to the client's care.

Choice C rationale:

This is the most appropriate response because it ensures that the client receives a comprehensive assessment and individualized treatment plan from a qualified healthcare provider.

The provider can evaluate the client's symptoms, medical history, and potential risk factors to determine if oseltamivir is a suitable medication.

Additionally, the provider can discuss other potential treatment options, such as over-the-counter medications for symptom relief, and provide guidance on self-care measures to promote recovery.

Choice D rationale:

While over-the-counter medications can help manage some symptoms of influenza, such as fever, aches, and cough, they do not directly target the virus itself.

Antiviral medications like oseltamivir can potentially shorten the duration of the illness and reduce the risk of complications, especially in individuals at higher risk.

Therefore, relying solely on over-the-counter medications without considering antiviral therapy could potentially delay recovery and increase the likelihood of adverse outcomes.

A. Chronic pain related to tissue destruction by tumor. B. Anxiety and grieving related to progression of disease. C. Risk for aspiration related to difficulty swallowing. D. Imbalanced nutrition: less than body requirements.

Correct Answer is C

Explanation

Choice A rationale:

Chronic pain is a significant concern for this client, but it is not the immediate priority. Pain can be managed with medications and comfort measures, while aspiration can be life-threatening.

Tissue destruction by the tumor is likely contributing to the pain, but addressing the risk of aspiration takes precedence.

Uncontrolled pain can exacerbate anxiety and make it difficult to focus on other interventions, but ensuring airway safety is paramount.

Choice B rationale:

Anxiety and grieving are expected reactions to a diagnosis of esophageal cancer, and they should be addressed as part of the client's care plan. However, they are not the immediate priority in this case.

The progression of the disease is a significant stressor, but attending to the risk of aspiration is essential for the client's safety. Psychological distress can negatively impact coping and quality of life, but addressing physical needs takes precedence.

Choice D rationale:

Imbalanced nutrition is a concern for this client due to dysphagia and anorexia. However, it is not the immediate priority. Nutritional interventions can be implemented once the risk of aspiration is addressed.

Difficulty swallowing can lead to inadequate intake and malnutrition, but ensuring airway safety is the primary concern.

Anorexia can further contribute to nutritional deficits, but preventing aspiration is the most pressing issue.

Choice C is the priority nursing problem because:

The client's dysphagia puts them at immediate risk for aspiration, which can lead to pneumonia, respiratory failure, and even death.

Addressing the risk of aspiration is essential to ensure the client's safety and prevent life-threatening complications. It's crucial to implement interventions to minimize the risk of aspiration, such as:

Elevating the head of the bed during meals and for 30-60 minutes after eating Thickening liquids and pureeing foods

Encouraging small, frequent meals

Monitoring for signs of aspiration, such as coughing, choking, or difficulty breathing

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with symptoms of influenza that started the previous day asks the clinic nurse about taking oseltamivir to treat the infection.Which response should the nurse provide?

Correct Answer is C

Explanation

The nurse is caring for a client who has been admitted with a diagnosis of esophageal cancer.The client reports a pain level of 8 on a 0 to 10 pain scale, dysphagia, anorexia, anxiety, and a hoarse voice. Which nursing problem is the priority for this client?

Correct Answer is C

Explanation

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