A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the
following interventions in the plan?
Provide the client with a low protein diet.
Instruct the client to use pursed-lip breathing.
Restrict the client's fluid intake to less than 2 L/day.
Have the client use the early-morning hours for exercise and activity.
The Correct Answer is B
Pursed-lip breathing is a technique that helps clients with COPD to exhale more effectively and prevent air trapping in the lungs. It also reduces dyspnea and improves oxygenation.
a) A low protein diet is not recommended for clients with COPD, as they need adequate protein intake to maintain muscle mass and prevent malnutrition.
c) Fluid restriction is not necessary for clients with COPD, unless they have signs of fluid overload or heart failure. Adequate hydration helps to thin secretions and facilitate expectoration.
d) Early-morning hours are not the best time for exercise and activity for clients with COPD, as they may experience more shortness of breath and fatigue due to diurnal variations in lung function. A better time would be mid-morning or afternoon, after taking bronchodilators and clearing secretions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["100"]
Explanation
To calculate the infusion rate, use the formula:
mL/hr = (volume of solution in mL / time of infusion in hr) x 60 min/hr
Plug in the given values:
mL/hr = (50 mL / 0.5 hr) x 60 min/hr
Simplify and solve:
mL/hr = 100 x 60 min/hr
mL/hr = 100 mL/hr
Round to the nearest whole number and add a leading zero if needed:
mL/hr = 100 mL/hr
Correct Answer is B
Explanation
Repositioning the client is the appropriate action for the nurse to take, as chest burning may indicate that the chest tube is kinked, twisted, or compressed, which can impair drainage and ventilation. The nurse should gently move the client to a different position and check that the chest tube is not bent or occluded by clothing, bedding, or furniture. The nurse should also ensure that there are no dependent loops or coils in the tubing and that it is secured to prevent dislodgment.
a) Increasing the client's wall suction is not advisable, as it can cause increased negative pressure in the pleural space and lead to tension pneumothorax. Increasing the wall suction does not affect the patency of the chest tube or the drainage of air or fluid from the lung. The nurse should maintain the wall suction at the prescribed level and monitor for any changes in the suction chamber.
c) Clamping the client's chest tube is not advisable, as it can cause air or fluid accumulation in the pleural space and lead to tension pneumothorax. Clamping the chest tube does not relieve chest burning or improve drainage or ventilation. The nurse should only clamp the chest tube for a brief period of time and under specific circumstances, such as changing the drainage system, assessing for an air leak, or preparing for chest tube removal.
d) Stripping the client's chest tube is not advisable, as it can cause increased negative pressure in the pleural space and lead to tissue damage or bleeding. Stripping the chest tube involves applying manual pressure along the tubing to force out any clots or debris that may obstruct drainage. However, this practice is not recommended, as it can cause more harm than good. The nurse should only milk the chest tube gently and intermittently if ordered by the provider and if there is evidence of obstruction.
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