When teaching a client about foods that do not increase blood glucose, which should the nurse include?

Choice A reason: Avoiding sick people and washing hands is the most important client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, as it can reduce the exposure to respiratory infections, which are the main cause of COPD exacerbations. The nurse would advise the older adult to stay away from people who have colds, flu, or other contagious illnesses, and to wash their hands frequently with soap and water or use alcohol-based hand sanitizer.

Choice B reason: Using low-flow oxygen for dyspnea is a possible client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it depends on the severity of the condition and the oxygen saturation level of the patient. The nurse would advise the older adult to use oxygen therapy as prescribed by their doctor, and to monitor their oxygen level with a pulse oximeter.

Choice C reason: Easing breathing by sitting upright is a helpful client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a supportive measure that does not address the underlying cause of the exacerbation. The nurse would advise the older adult to sit upright or lean forward when they have difficulty breathing, and to use pursed-lip breathing or abdominal breathing techniques.

Choice D reason: Eating nutrient- and calorie-dense foods is a beneficial client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a long-term strategy that does not prevent the immediate risk of exacerbation. The nurse would advise the older adult to eat a balanced diet that provides enough protein, carbohydrates, fats, vitamins, and minerals, and to avoid foods that can cause gas, bloating, or reflux.

Choice A reason: Older adult's self-report is a subjective measure of pain that may not reflect the actual intensity or quality of pain. It may also be influenced by factors such as cognitive impairment, mood, or cultural norms.

Choice B reason: FPSR stands for Face, Pain Scale-Revised, which is a tool to assess pain in infants and children who cannot verbalize their pain. It is not suitable for older adults, who may have different facial expressions or reactions to pain.

Choice C reason: Pain medication frequency is an indirect measure of pain that may not capture the effectiveness or side effects of pharmacotherapy. It may also vary depending on the type, dose, and route of administration of pain medication.

Choice D reason: Older adult's pain diary is a comprehensive and reliable measure of pain that can track the changes in pain level, quality, and location over time. It can also record the impact of pain on daily activities, mood, sleep, and quality of life. It can help the nurse to evaluate the outcomes of comfort measures and pharmacotherapy, and to adjust the pain management plan accordingly.