Which intervention would be appropriate for a client with shortness of breath?

Maintain the patient in a supine position during rest.

Monitor the client's oxygen saturation hourly.

Ambulate the client in the hall four times daily.

Encourage high protein foods during mealtime.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Maintaining the patient in a supine position during rest would not be appropriate for a client with shortness of breath. This position can worsen breathing difficulties, especially in clients with respiratory issues. It reduces lung expansion and can lead to increased work of breathing.

Choice B rationale:

Monitoring the client's oxygen saturation hourly is the appropriate intervention for a client with shortness of breath. Oxygen saturation (SpO2) levels indicate the percentage of oxygen bound to hemoglobin in the blood. Monitoring SpO2 levels helps assess the client's oxygenation status and provides crucial information about the effectiveness of respiratory interventions. Normal oxygen saturation levels typically range between 95% to 100%. Monitoring allows timely recognition of hypoxemia, enabling prompt intervention to improve oxygenation and prevent complications.

Choice C rationale:

Ambulating the client in the hall four times daily may not be suitable for a client experiencing shortness of breath, as it can exacerbate respiratory distress. Ambulation increases oxygen demand and can further compromise oxygenation in individuals struggling to breathe.

Choice D rationale:

Encouraging high protein foods during mealtime is unrelated to the immediate management of shortness of breath. While proper nutrition is essential for overall health and healing, it does not directly address the acute issue of respiratory distress.

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Correct Answer is C

Explanation

Choice A rationale:

During inhalation, carbon dioxide levels are lower in the alveoli due to the exchange of gases. The higher concentration of carbon dioxide is found in the blood, which diffuses into the alveoli for elimination during exhalation.

Choice B rationale:

Alveoli do not collapse during the inhalation cycle. Surfactant, a substance produced by type II alveolar cells, reduces surface tension and prevents alveoli from collapsing, ensuring efficient gas exchange.

Choice C rationale:

Oxygen moves from the alveoli to the capillaries, while carbon dioxide moves from the capillaries to the alveoli. This exchange of gases occurs due to differences in partial pressures, facilitating the uptake of oxygen by red blood cells and the removal of carbon dioxide from the body.

Choice D rationale:

Exhaling carbon dioxide is a passive process that does not require significant effort. The respiratory muscles relax during exhalation, allowing the lungs to passively expel carbon dioxide from the body as a waste product of metabolism.

A. Place the mouthpiece in the mouth and inhale through the mouthpiece. B. Set an alarm to ring every hour at night to use the incentive spirometer. C. Use the incentive spirometer only when shortness of breath occurs. D. Inhale normally and then cough forcefully into the mouthpiece of the device.

Correct Answer is A

Explanation

Choice A rationale:

The correct technique for using an incentive spirometer involves placing the mouthpiece in the mouth and inhaling slowly and deeply through the mouthpiece. This helps the client to take deep breaths, expand their lungs, and improve lung function. By inhaling through the mouthpiece, the client maximizes the benefits of the incentive spirometer, preventing complications such as atelectasis and pneumonia.

Choice B rationale:

Setting an alarm to ring every hour at night is not relevant to using the incentive spirometer. The frequency of using the incentive spirometer should be determined based on the healthcare provider's recommendation and the client's condition. Using it too frequently or infrequently can both have negative consequences.

Choice C rationale:

Using the incentive spirometer only when shortness of breath occurs is not the correct approach. Incentive spirometry is a preventive measure used to maintain lung function and prevent respiratory complications, especially after surgery. Waiting until shortness of breath occurs might be too late to prevent complications effectively.

Choice D rationale:

Inhaling normally and then coughing forcefully into the mouthpiece of the device is not the correct technique for using an incentive spirometer. Coughing into the device can damage it and render it ineffective. Inhaling deeply and slowly through the mouthpiece is the correct method to encourage optimal lung expansion and prevent respiratory complications.

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Which intervention would be appropriate for a client with shortness of breath?

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