A nurse is caring for a client who has COPD and is 5 kg (11 lb) below her ideal body weight. The client experiences shortness of breath when eating. Which of the following actions should the nurse take?
Administer a bronchodilator following meals.
Limit the client's food consumption between meals.
Arrange for a low-protein diet.
Request non-gas-forming foods from the dietary department.
The Correct Answer is D
Rationale:
A. Administer a bronchodilator following meals: Bronchodilators should be administered before meals, not after, to help relieve shortness of breath and improve the client’s ability to eat without fatigue or dyspnea. Giving them afterward does not assist with eating difficulties.
B. Limit the client's food consumption between meals: Restricting food intake between meals would reduce overall caloric intake, which is counterproductive for a client who is underweight and experiencing nutritional deficits due to COPD. Frequent small meals are usually recommended.
C. Arrange for a low-protein diet: Clients with COPD who are underweight often need adequate protein to maintain muscle mass and respiratory function. A low-protein diet could worsen malnutrition and impair recovery.
D. Request non-gas-forming foods from the dietary department: Non-gas-forming foods reduce bloating and abdominal discomfort, which can make eating easier for clients with COPD who experience dyspnea. This intervention supports improved caloric intake and minimizes respiratory compromise during meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}
Explanation
Rationale:
• Stay with the client for the first 15 min of the transfusion: The first 15 minutes of a blood transfusion are critical for monitoring signs of a transfusion reaction, such as fever, chills, rash, or hypotension. Continuous observation allows the nurse to promptly intervene and prevent complications.
• Obtain the first unit of packed RBCs from the blood bank: Retrieving the blood from the blood bank ensures that the correct product is available for transfusion and meets safety protocols. Verification of type and crossmatch is essential before administration.
• Document the blood product transfusion in the client's medical record: Accurate documentation of the transfusion, including product type, volume, time, and client response, is required for legal, medical, and safety purposes. It ensures continuity of care and provides a record for any adverse events.
• Start an IV bolus of lactated Ringers solution: Routine IV bolus of lactated Ringer’s is not indicated unless the client has persistent hypotension requiring fluid resuscitation. Blood transfusion itself is the primary intervention to correct anemia in this client.
• Titrate the rate of infusion to maintain the client's blood pressure at least 90/60 mm Hg: While monitoring blood pressure is important, adjusting the transfusion rate specifically to maintain a numeric BP is not standard practice. The transfusion rate should follow protocol, usually starting slow for the first 15 minutes and then adjusted per tolerance, not solely based on BP.
Correct Answer is ["B","D","E"]
Explanation
Rationale:
A. Magnesium sulfate: Magnesium sulfate does not have significant interactions with warfarin and is not contraindicated. It can be safely administered with appropriate monitoring, making it safe in this context.
B. Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with warfarin. It inhibits platelet function and can potentiate anticoagulation, making it contraindicated.
C. Cetirizine: Cetirizine is an antihistamine that does not significantly affect coagulation or interact with warfarin. It can be safely used with warfarin under normal circumstances.
D. Gingko biloba: Gingko biloba can increase the risk of bleeding by inhibiting platelet aggregation. Clients on warfarin should avoid herbal supplements like gingko that can potentiate anticoagulation effects.
E. Aspirin: Aspirin has antiplatelet effects and can significantly increase the risk of bleeding when combined with warfarin. Concurrent use is generally contraindicated unless specifically approved and closely monitored by the provider.
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