A nurse is collecting data from a client who has emphysema. Which of the following findings should the nurse expect? (Select all that apply.)

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. Treatment is not needed if the client is asymptomatic.

Even asymptomatic pulmonary embolisms can lead to complications such as progression to symptomatic PE or development of chronic thromboembolic pulmonary hypertension. Therefore, treatment is necessary to prevent these complications.

B. Treatment is not needed if the pulmonary embolism is intermediate.

The severity of a pulmonary embolism is determined by various factors, including the size and location of the clot and the degree of obstruction in the pulmonary arteries. Intermediate-risk pulmonary embolisms still require treatment to prevent complications and reduce the risk of progression to a more severe or life-threatening condition.

C. Treatment is not needed if the client is hemodynamically stable.

Hemodynamic stability refers to the client's circulatory status and whether they are maintaining adequate blood flow to vital organs. While hemodynamically stable clients may not require aggressive interventions such as thrombolytic therapy or surgical embolectomy, they still require anticoagulant therapy to prevent further clot formation and reduce the risk of complications.

D. Treatment is needed for all clients who have a pulmonary embolism.

Pulmonary embolism (PE) is a serious and potentially life-threatening condition that requires prompt treatment. Regardless of the severity of symptoms or the client's hemodynamic stability, treatment is necessary to prevent complications and reduce the risk of recurrence. Treatment typically includes anticoagulant therapy to prevent further clot formation and may include additional interventions such as thrombolytic therapy or surgical interventions in certain cases.