A charge nurse on a medical-surgical unit is anticipating an emergency response plan following an external disaster in the community. Which of the following current clients should the nurse recommend for early discharge?

Choice A reason: Performing postural drainage immediately after meals risks aspiration and discomfort due to gastric contents shifting during positioning. It should be done 1-2 hours after meals to ensure safety and efficacy in clearing mucus from the lungs, making this timing inappropriate for cystic fibrosis management.
Choice B reason: Performing postural drainage twice daily is recommended for cystic fibrosis to mobilize thick mucus from the lungs, improving airway clearance and reducing infection risk. This frequency balances effectiveness with patient tolerance, aligning with evidence-based guidelines for managing chronic respiratory conditions, making it the correct action.
Choice C reason: Using a percussion vest is an alternative to manual postural drainage but is not specified as the only method. Manual techniques are effective and standard unless a vest is prescribed. This choice assumes equipment availability, which may not apply, making it less universally appropriate than scheduled manual drainage.
Choice D reason: Positioning the child flat during postural drainage is incorrect, as specific angled positions (e.g., head-down) are needed to target lung segments and promote mucus drainage by gravity. Flat positioning reduces effectiveness and may not clear airways adequately, making this an inappropriate technique for cystic fibrosis.

Choice A reason: Decreasing fluid intake to firm stools is incorrect, as adequate hydration (2-3 L/day) is essential to prevent constipation, especially with opioids like oxycodone, which slow intestinal motility. Low fluid intake hardens stools, exacerbating constipation risk by reducing water content in the colon, indicating a misunderstanding of prevention strategies.
Choice B reason: Increasing dietary fiber intake (25-35 g/day) adds bulk to stools, stimulating peristalsis and counteracting opioid-induced slowed motility. Soluble and insoluble fiber, found in fruits, vegetables, and whole grains, promotes regular bowel movements. This statement reflects correct understanding of dietary measures to prevent constipation during opioid therapy.
Choice C reason: Taking a laxative only when constipated is reactive, not preventive. Opioids like oxycodone commonly cause constipation by reducing peristalsis via mu-opioid receptors in the gut. Prophylactic use of stool softeners or laxatives is recommended to maintain regular bowel movements, making this statement incorrect as it lacks a preventive approach.
Choice D reason: Exercising less to conserve energy worsens constipation, as physical activity stimulates intestinal motility, countering opioid-induced slowing. Regular movement, like walking, promotes bowel function by enhancing peristalsis and blood flow to the gut. This statement indicates a misunderstanding, as reduced activity increases constipation risk.