A nurse is developing a nutritional care plan for a client who has COPD and severe dyspnea.
To promote intake, which of the following actions should the nurse include in the plan of care?

Administer a bronchodilator after meals.

Ambulate the client before each meal.

Limit fluid intake with meals.

Offer the client three large meals each day.

Answer and Explanation

The Correct Answer is C

The correct answer is choice c. Limit fluid intake with meals.

Choice A rationale:

Administering a bronchodilator after meals is not ideal because bronchodilators are typically given before meals to help open the airways and make breathing easier during eating.

Choice B rationale:

Ambulating the client before each meal might cause fatigue, making it harder for the client to eat and potentially decreasing their overall intake.

Choice C rationale:

Limiting fluid intake with meals can help prevent the client from feeling too full, which can make it easier for them to consume more solid food. This is particularly important for clients with COPD who may already have a reduced appetite and difficulty eating large amounts at once.

Choice D rationale:

Offering three large meals each day is not recommended for clients with COPD. Smaller, more frequent meals are generally better tolerated and can help prevent the feeling of fullness that can make breathing more difficult.

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Correct Answer is D

Explanation

Choice A rationale:

Maintaining eye contact with the newborn during feedings is a general caregiving practice and is not specific to managing neonatal abstinence syndrome. While eye contact and bonding are important for newborns, it does not address the symptoms of neonatal abstinence syndrome.

Choice B rationale:

Swaddling the newborn with his legs extended is not a specific action for managing neonatal abstinence syndrome. However, swaddling can provide comfort to some infants, but the positioning of the legs is not directly related to managing symptoms of withdrawal.

Choice C rationale:

Administering naloxone to the newborn is not a standard practice for managing neonatal abstinence syndrome. Naloxone is an opioid antagonist used to reverse opioid overdose in adults and is not typically used in newborns unless there are specific indications, which are rare.

A. Vitamin B12. B. Ranitidine. C. Vitamin K. D. Metoclopramide.

Correct Answer is A

Explanation

Choice A rationale:

After a total gastrectomy, the client lacks the intrinsic factor necessary for the absorption of vitamin B12 in the terminal ileum. Therefore, vitamin B12 supplementation is essential to prevent pernicious anemia, a condition caused by vitamin B12 deficiency. The absence of intrinsic factor hinders the absorption of vitamin B12 from dietary sources, making it necessary to provide this vitamin through injections or high-dose oral supplements. Vitamin B12 supplementation is a standard practice following a total gastrectomy.

Choice B rationale:

Ranitidine is a histamine-2 (H2) receptor antagonist used to reduce stomach acid production. It is not directly related to vitamin B12 deficiency and is not typically prescribed following a total gastrectomy. Vitamin B12 supplementation, on the other hand, addresses the specific deficiency caused by the absence of intrinsic factor.

Choice C rationale:

Vitamin K is essential for blood clotting and bone health. However, it is not the primary concern following a total gastrectomy. Vitamin B12 deficiency leading to pernicious anemia is the major focus of post-gastrectomy supplementation. While vitamin K may be important for overall health, it is not the immediate priority in this scenario.

Choice D rationale:

Metoclopramide is a medication used to treat gastrointestinal disorders, including gastroparesis and gastroesophageal reflux disease (GERD). It does not directly address the vitamin B12 deficiency resulting from the absence of intrinsic factor. Vitamin B12 supplementation is specifically indicated to prevent pernicious anemia in this context.

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A nurse is developing a nutritional care plan for a client who has COPD and severe dyspnea. To promote intake, which of the following actions should the nurse include in the plan of care?

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A nurse is developing a nutritional care plan for a client who has COPD and severe dyspnea.
To promote intake, which of the following actions should the nurse include in the plan of care?