A nurse is caring for a client with a medical diagnosis of acute exacerbation of chronic obstructive pulmonary disease (COPD). The client's assessment reveals a respiratory rate of 28/min, SpO2 at 90%, and complaints of mild dyspnea and anxiety at rest. What should the nurse include in the client's discharge teaching plan?

Use bronchodilators every 2 hours as needed.

Instructions on pursed-lip breathing.

Increase home oxygen from 3L/min to 5L/min as needed.

Use huff coughing to loosen secretions.

Answer and Explanation

The Correct Answer is B

Choice A reason:
Using bronchodilators every 2 hours as needed may not be appropriate for all clients. Bronchodilators are typically used on a schedule or as needed based on symptoms, but overuse can lead to tolerance and decreased effectiveness. The nurse should provide education on the proper use and timing of bronchodilators.

Choice B reason:
Pursed-lip breathing is a technique that helps control shortness of breath and improve ventilation. It can slow down the client's breathing, promote relaxation, and ensure more effective lung function. This technique is particularly beneficial during an acute exacerbation of COPD and should be included in the discharge teaching plan.

Choice C reason:
Increasing home oxygen without proper assessment can be dangerous. Oxygen therapy should be titrated based on the client's oxygen saturation and clinical status. Clients with COPD are at risk of CO2 retention, and too much oxygen can suppress their drive to breathe. The nurse should educate the client on monitoring their SpO2 and when to adjust oxygen levels, typically under the guidance of a healthcare provider.

Choice D reason:
Huff coughing is a technique used to clear mucus from the airways. While it can be effective, it should be taught by a respiratory therapist or nurse who can assess the client's ability to perform the technique correctly. It is not the first-line teaching for a client being discharged with an acute exacerbation of COPD.

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Correct Answer is A

Explanation

Choice A Reason:
Sodium levels in the blood should normally be between 135 and 145 mEq/L. A level of 152 mEq/L is considered high and can be indicative of hypernatremia, which requires prompt medical attention to address potential dehydration, kidney issues, or other underlying conditions.

Choice B Reason:
Potassium levels should be within the range of 3.5 to 5.2 mEq/L for adults. A result of 3.8 mEq/L falls within the normal range, indicating no immediate concern regarding potassium levels.

Choice C Reason:
Calcium levels in the blood are typically between 8.6 and 10.2 mg/dL for adults. Therefore, a calcium level of 10.0 mg/dL is within the normal range and does not require urgent reporting to a physician.

Choice D Reason:
Creatinine levels in the blood should be between 0.6 to 1.3 mg/dL in adults, depending on factors such as age, gender, and muscle mass. A level of 1.2 mg/dL is at the higher end of the normal range but is not typically considered critical unless there are other signs of kidney dysfunction.

A. Include yogurt in the diet. B. Administer famotidine 20 mg daily while taking the antibiotic. C. Test stool for occult blood. D. Arrange for IV administration of the antibiotic instead of the oral route.

Correct Answer is A

Explanation

Choice a reason:
Including yogurt in the diet can be beneficial for a client experiencing diarrhea related to antibiotic therapy. Yogurt contains probiotics, which are live microorganisms that can provide health benefits when consumed. These probiotics can help restore the balance of good bacteria in the gut that antibiotics may have disrupted, potentially reducing the duration and severity of diarrhea. However, it's important to choose yogurts that contain active probiotics and to be aware that some individuals may not tolerate dairy well during a bout of diarrhea.

Choice b reason:
Administering famotidine 20 mg daily may help with symptoms of gastritis or peptic ulcers but is not directly related to treating antibiotic-associated diarrhea. Famotidine is a histamine-2 blocker used to reduce stomach acid and is not typically used as a treatment for diarrhea. It should be noted that if a patient is experiencing severe diarrhea, the underlying cause should be addressed rather than just managing symptoms.

Choice c reason:
Testing stool for occult blood is generally not a standard intervention for antibiotic-related diarrhea unless there is a suspicion of gastrointestinal bleeding or an infection like C. difficile, which can cause more severe colitis. Occult blood tests are more commonly used for screening for colorectal cancer or diagnosing conditions that cause gastrointestinal bleeding.

Choice d reason:
Arranging for IV administration of the antibiotic instead of the oral route may be considered if the client has severe diarrhea that prevents the absorption of oral medications or if the client is unable to tolerate oral intake[^10^]¹¹¹²¹³¹⁴. However, many antibiotics have excellent oral bioavailability, and switching from IV to oral antibiotics when appropriate can be just as effective and is often preferred due to convenience and lower risk of complications.

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing pre-operative laboratory studies of an adult client on a medical-surgical unit. Which result should be reported to the physician immediately?

Correct Answer is A

Explanation

The nurse would include which teaching or intervention in the care plan of a client experiencing diarrhea related to antibiotic therapy?

Correct Answer is A

Explanation

Which nursing action(s) should the nurse include in the post-op plan of care for a client recovering from a below-the-knee amputation?

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