A nurse is caring for a client who is at 10 weeks of gestation and reports difficulty sleeping due to frequent urges to urinate throughout the night. Which of the following recommendations should the nurse make?

Rationale:

A. "You can apply counterpressure to your back with each position change.": Counterpressure is commonly used during labor to relieve back pain caused by fetal positioning. It is not relevant for postoperative cesarean pain, which is abdominal.

B. "You should change positions as little as possible.": Limiting movement after surgery can increase the risk of complications such as pneumonia and venous thromboembolism. Frequent, supported movement is encouraged to promote recovery and circulation.

C. "You should use patterned-paced breathing when changing positions.": Patterned-paced breathing is typically used during labor for pain management. While breathing techniques may offer mild comfort, they do not provide adequate support for incisional pain during movement.

D. "You can splint the incision with a pillow when changing positions.": Splinting the incision with a pillow provides support to the abdominal muscles, helping reduce tension and pain during movement. This is a safe and effective nonpharmacological strategy for post-cesarean clients.

Rationale:

A. "I should do aerobic exercises once per day.": While exercise is beneficial for clients with COPD, it should be individualized and not necessarily done daily, especially in the beginning. Overexertion can worsen symptoms, so gradual and well-monitored activity is recommended.

B. "I will increase my fluid intake to 1,700 milliliters per day.": Clients with COPD are typically encouraged to consume 2,000 to 2,500 mL of fluids daily unless contraindicated. Higher fluid intake helps thin secretions, making them easier to expectorate and improving airway clearance.

C. "I should practice pursed-lip breathing exercises.": Pursed-lip breathing improves ventilation by keeping airways open longer during exhalation, reducing air trapping and dyspnea. It is a fundamental breathing technique taught to clients with COPD to improve oxygenation and control shortness of breath.

D. "I will consume low-protein, low-calorie foods.": Clients with COPD often have increased energy demands due to the work of breathing. A high-protein, high-calorie diet is typically recommended to prevent muscle wasting and support respiratory muscle strength.