A nurse in a provider's office is reinforcing teaching about cigarette smoking with a client. Which of the following adverse effects should the nurse include in the teaching?

Choice A Reason:

Limiting fluid intake to 750 mL per day is not recommended, as adequate hydration is essential for overall health. The client should maintain good hydration unless specifically advised otherwise by their healthcare provider.

Choice B Reason:

Cleansing the neck by rubbing with a washcloth may be too harsh for the irradiated skin. The skin in the radiation field can become sensitive and may require gentle cleansing with mild soap and patting dry, rather than rubbing.

Choice C Reason:

Eating three large meals each day may not be suitable for all clients undergoing radiation therapy, especially if they are experiencing side effects such as difficulty swallowing or changes in taste. Dietary recommendations should be individualized based on the client's specific needs and symptoms. Smaller, more frequent meals may be more manageable for some clients.

Choice D Reason:

Avoiding exposing the neck to the cold is correct. When providing instructions to a client undergoing radiation therapy to the neck, it's important to emphasize the need to protect the treated area from extreme temperature changes. Exposure to cold temperatures can cause vasoconstriction and potentially lead to tissue damage in the irradiated area. Therefore, advising the client to avoid exposing the neck to cold is a vital precaution.

Choice A Reason:

"I should do aerobic exercises once per day." While exercise is important for individuals with COPD, the frequency and intensity of exercise should be determined based on the individual's condition and healthcare provider's recommendations. One-size-fits-all recommendations may not apply to all clients.

Choice B Reason:

"I should practice pursed-lip breathing exercises." Pursed-lip breathing exercises are a beneficial technique for individuals with COPD. This technique can help improve breathing efficiency and decrease shortness of breath. Clients with COPD are often taught to use pursed-lip breathing during activities that require increased effort or when experiencing shortness of breath.

Choice C Reason:

"I will increase my fluid intake to 1,700 milliliters per day." While staying adequately hydrated is essential, the specific fluid intake should be determined based on the client's needs, medical condition, and healthcare provider's advice. The recommended daily fluid intake can vary among individuals.

Choice D Reason:

"I will consume low-protein, low-calorie foods." Nutrition is an important aspect of COPD management, but the dietary recommendations should be tailored to the client's specific needs, including their nutritional status, energy expenditure, and other factors. A generalized statement about low-protein, low-calorie foods may not be appropriate for all individuals with COPD.