A nurse is caring for a client who has COPD. Which of the following actions should the nurse take?

A. Encourage the client to drink 8 glasses of water a day.

This is the correct choice. Clients with COPD often have thickened respiratory secretions due to chronic inflammation and mucus production. Adequate hydration helps to keep these secretions thin, making them easier to cough up and clear from the airways. Encouraging the client to drink plenty of fluids, such as water, can assist in maintaining optimal hydration levels and promoting effective airway clearance.

B. Instruct the client to cough every 4 hours.

Instructing the client to cough on a scheduled basis, such as every 4 hours, is not appropriate for managing COPD. While coughing is important for clearing respiratory secretions, the frequency of coughing should be based on the client's individual needs and symptoms. Some clients with COPD may need to cough more frequently, while others may need to cough less often. It's important to encourage the client to cough as needed to clear secretions rather than on a predetermined schedule.

C. Provide the client with a low-protein diet.

Providing the client with a low-protein diet is not recommended for managing COPD. Adequate protein intake is important for maintaining muscle strength, including respiratory muscles, and supporting overall health. Clients with COPD may have increased energy needs due to the increased work of breathing and should be encouraged to consume a balanced diet that includes adequate protein.

D. Advise the client to lie down after eating.

Advising the client to lie down after eating is not recommended for managing COPD. Lying down after eating can increase pressure on the diaphragm and make breathing more difficult, especially for individuals with compromised lung function. It's generally recommended for individuals with COPD to remain in an upright position after eating to minimize respiratory discomfort and reduce the risk of aspiration.

A. Prepare the client for endotracheal suctioning.

Endotracheal suctioning is a procedure used to clear secretions from the airway, which may be necessary in cases of respiratory distress. However, it is not the first action to take in this scenario. Before proceeding with suctioning, the nurse should first assess the client's respiratory status and implement interventions to improve ventilation and oxygenation.

B. Elevate the head of the bed.

This is the correct action to take first. Elevating the head of the bed helps improve the client's respiratory mechanics by allowing better lung expansion and reducing the work of breathing. It also helps alleviate symptoms of respiratory distress. This intervention should be implemented immediately to optimize the client's breathing.

C. Request a chest x-ray.

While a chest x-ray may provide valuable information about the client's respiratory status, it is not the first action to take in this acute situation. Chest x-rays require time to be performed and interpreted, which may delay necessary interventions to address the client's immediate respiratory distress.

D. Obtain a sputum culture.

Obtaining a sputum culture may be indicated to identify the underlying cause of respiratory distress, such as infection. However, it is not the first action to take when the client is experiencing acute respiratory distress. The priority is to implement interventions to improve ventilation and oxygenation to stabilize the client's condition.