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Systemic corticosteroids are well-known to increase blood glucose levels, but short-acting beta2 agonists like albuterol do not typically have this metabolic effect. Therefore, the client's statement regarding hyperglycemia is clinically incorrect for this specific rescue inhaler and would indicate a need for further medication clarification.

Unlike inhaled or systemic corticosteroids which can cause localized or systemic immune suppression, albuterol does not impair the body’s defenses. It is a bronchodilator with no anti-inflammatory or immunosuppressive properties, making this statement an incorrect understanding of how the drug affects the client's overall health.

Development of mouth sores or oral candidiasis is a classic side effect associated with inhaled corticosteroids, not bronchodilators like albuterol. These fungal infections occur due to local immunosuppression in the oropharynx, whereas albuterol’s side effect profile is primarily related to nervous system and cardiovascular stimulation.

The client is confusing the incentive spirometer with a pulse oximeter, which non-invasively monitors arterial oxygen saturation. An incentive spirometer is a mechanical breathing tool requiring active patient participation through inhalation. It is not a passive sensor attached to the finger or earlobe.

Patients should be positioned in a high-Fowler or semi-Fowler position to allow for maximum diaphragmatic excursion and chest wall expansion. Recumbent positioning increases abdominal pressure against the diaphragm. This significantly hinders the patient's ability to achieve the deep inspiratory volumes required for effective therapy.

Placing a hand over the abdomen is a technique used in diaphragmatic breathing to monitor muscle movement. It does not add resistance to the incentive spirometer. The device provides visual feedback for flow, and manual resistance would be counterproductive to achieving a slow, deep inspiratory effort.

Partial rebreathing masks are generally used for short-term therapy in patients who require higher oxygen concentrations during acute respiratory distress. They are not suitable for long-term therapy because the mask is hot, confining, and interferes with essential activities like eating and talking. Long-term management typically utilizes more stable and comfortable devices like a nasal cannula.

The non-rebreather mask, not the partial rebreather, provides the highest oxygen concentrations (up to 90% to 100%). The non-rebreather is equipped with one-way valves that prevent any exhaled air from entering the reservoir bag and prevent room air from entering the mask. The partial rebreather allows some mixing of air, resulting in a lower fraction of inspired oxygen (FiO2).

The nasal cannula is the device that is most comfortable and causes the least restriction on the patient's activities. It allows the client to eat, drink, and speak without interrupting the oxygen flow. Masks, by contrast, are more restrictive and can cause skin breakdown over the bridge of the nose and behind the ears during prolonged use.

Standard nursing protocols typically recommend scheduling the procedure at least 2 hours after meals to minimize the risk of vomiting or aspiration. A timeframe of only 1 hour after a meal is insufficient and could lead to gastric distress. Positional changes require an empty stomach to ensure patient safety and comfort.

Effective airway clearance requires the patient to remain in the drainage position for several minutes to allow gravity to mobilize the secretions. A cough before positioning is counterproductive because the mucus has not yet moved into the larger, central airways. The final step of the procedure should be expectoration once secretions have migrated.

The correct clinical sequence requires the nurse to place the patient in the appropriate positioning first before applying manual techniques like percussion or vibration. These adjunctive maneuvers are specifically designed to shake secretions loose while the lung segment is superior to the carina. This ensures that the loosened mucus moves toward the trachea immediately.

Administration of routine medications is a necessary component of long-term management but does not address the immediate, acute distress. The nurse must prioritize non-pharmacological stabilization techniques that offer instant relief before waiting for the onset of pharmacological agents. Routine orders may not be sufficient during an acute exacerbation requiring rapid stabilization.

Chest physiotherapy is an intensive procedure that can actually increase the oxygen demand and worsen the anxiety of a patient. Such techniques are generally reserved for periods of stability to manage chronic secretions. Performing percussion during an active dyspneic episode can further compromise the patient’s limited respiratory reserve and increase the physical workload.

Delivery of oxygen at 5 L/min is inappropriately high for a COPD patient and carries the risk of suppressing the hypoxic respiratory drive. Excessive oxygenation can lead to carbon dioxide retention and worsening respiratory acidosis. Oxygen therapy must be titrated carefully to maintain a saturation between 88% and 92% rather than using high flow rates.