A nurse is contributing to the plan of care for a client who has COPD. Which of the following interventions should the nurse include in the plan of care?
Instruct the client to use pursed-lip breathing.
Plan to have the client lay down for 1 hr after meals.
Restrict the client’s fluid intake to less than 1 L/day.
Encourage the client to use the upper chest for respiration.
The Correct Answer is A
Pursed-lip breathing is a technique that helps to slow down the breathing rate and keep the airways open longer. This improves gas exchange and reduces the work of breathing. Pursed-lip breathing also helps to prevent air trapping and hyperinflation of the lungs, which are common complications of COPD.
Choice B is wrong because laying down for 1 hour after meals can increase the pressure on the diaphragm and make breathing more difficult. It can also increase the risk of aspiration and reflux.
Choice C is wrong because restricting the client’s fluid intake to less than 1 L/day can lead to dehydration and thickening of secretions, which can obstruct the airways and impair gas exchange. Fluid intake should be adequate to maintain hydration and thin secretions.
Choice D is wrong because using the upper chest for respiration is a sign of inefficient breathing and respiratory distress.
It can increase the oxygen demand and cause fatigue. The client should be encouraged to use the diaphragm and abdominal muscles for respiration, which are more efficient and reduce the work of breathing.
Normal ranges for oxygen saturation are 95% to 100%, for arterial blood gas pH are 7.35 to 7.45, for PaCO2 are 35 to 45 mmHg, for PaO2 are 80 to 100 mmHg, and for HCO3 are 22 to 26 mEq/L.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A lack of insurance or lack of sufficient insurance is a huge barrier in accessing health care. According to the Kaiser Family Foundation, uninsured people are less likely to receive preventive care and services for major health conditions and chronic diseases. They also face greater difficulties in affording care and paying medical bills.
Choice B is wrong because politics is not the only factor that affects the availability and affordability of health insurance. Other factors include income, employment status, age, health status, and geographic location. Nurses have a professional and ethical responsibility to advocate for the health needs of their clients and communities, which may involve engaging with political issues. Choice C is wrong because language is not the only problem for uninsured or underinsured clients. Other problems include cost, access, quality, and continuity of care. Language barriers may affect communication and understanding between clients and providers, but they can be addressed by using interpreters, translators, or culturally competent staff.
Choice D is wrong because the Joint Commission does not regulate insurance coverage. The Joint Commission is an independent, nonprofit organization that accredits and certifies health care organizations and programs in the United States. It sets standards for quality and safety of care, but it does not determine who is eligible for insurance or what benefits are covered.
Correct Answer is A
Explanation
The SBAR is used to organize and standardize communication between members of the health care team about a patient’s condition. It is an acronym for Situation, Background, Assessment, and Recommendation.
Choice B is wrong because the SBAR is not used to help Physical Therapy determine the client’s abilities.
Physical Therapy may use other tools or methods to assess the client’s functional status.
Choice C is wrong because the SBAR is not used to help physicians with diagnoses.
The SBAR is a communication tool, not a diagnostic tool.
Physicians may use other sources of information or tests to make diagnoses.
Choice D is wrong because the SBAR is not used to educate clients about their disease processes.
The SBAR is a tool for interprofessional communication, not for patient education.
Clients may receive education from other sources or materials.
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