A nurse is planning care for a client who has COPD with dyspneic episodes. Which of the following interventions should the nurse include?

Instruct the client to perform coughing exercises after meals.

Limit the client's fluid intake to 1,500 mL/day.

Encourage the client to sit in a chair for 1 hr several times per day.

Initiate oxygen therapy for the client via nasal cannula at 10 L/min.

Answer and Explanation

The Correct Answer is A

A) Instruct the client to perform coughing exercises after meals.
Coughing exercises after meals can help clear the airways of mucus, which is beneficial for clients with COPD. Effective airway clearance is crucial to improve breathing and reduce the risk of infections. This intervention can enhance respiratory function and comfort.

B) Limit the client's fluid intake to 1,500 mL/day.
Limiting fluid intake is generally not recommended for clients with COPD unless there is a specific medical reason, such as heart failure. Adequate hydration helps keep mucus thin and easier to expectorate, which is important for respiratory health.

C) Encourage the client to sit in a chair for 1 hr several times per day.
Encouraging the client to sit in a chair helps promote mobility and prevent complications associated with prolonged bed rest. However, while sitting up can improve lung expansion, it is not the most specific or direct intervention to address dyspneic episodes.

D) Initiate oxygen therapy for the client via nasal cannula at 10 L/min.
Administering oxygen at a high flow rate like 10 L/min is not typically appropriate for clients with COPD due to the risk of depressing their respiratory drive. Oxygen therapy should be carefully titrated and monitored based on the client's needs and blood gas levels.

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Correct Answer is B

Explanation

A) "I will offer my child apple juice instead of milk.": Offering apple juice instead of milk is not ideal for a toddler with failure to thrive. Milk is a better source of essential nutrients like calcium and vitamin D, which are important for growth and development. Juice can contribute to empty calories and should be limited.

B) "I should continue to feed my child when he pushes food out with his tongue.": This statement indicates an understanding of the importance of addressing feeding difficulties. In toddlers with Down syndrome, it is common to experience difficulties with feeding and swallowing. Continuing to offer food and using techniques to encourage eating, even when the child initially pushes food out, can help ensure adequate nutritional intake and support growth.

C) "I will provide his favorite food as a reward for good behavior.": Using food as a reward can lead to unhealthy eating habits and an association of food with behavior rather than hunger and nutrition. It’s better to use non-food rewards to encourage positive behavior.

D) "I should increase my child's vitamin A intake by feeding him raw carrot slices.": While vitamin A is important, raw carrots can be difficult for toddlers, especially those with developmental delays or oral-motor difficulties, to chew and swallow. Cooked carrots or other vitamin A-rich foods might be a safer option.

A. A potassium supplement B. A fiber supplement C. An anticonvulsant D. A diuretic

Correct Answer is D

Explanation

A) A potassium supplement: Administering a potassium supplement would be inappropriate for a client with a potassium level of 6.4 mEq/L. This level is above the normal range (3.5-5.0 mEq/L) and indicates hyperkalemia, which can have serious effects on cardiac function. Increasing potassium intake could exacerbate the condition.

B) A fiber supplement: While fiber supplements can be beneficial for overall digestive health, they do not directly address or correct an electrolyte imbalance like hyperkalemia. They are not relevant in managing elevated potassium levels.

C) An anticonvulsant: Anticonvulsants are used to manage seizure activity and are not indicated for treating hyperkalemia. They do not have any role in the regulation or management of potassium levels in the body.

D) A diuretic: Diuretics, particularly loop diuretics, are often used to help manage hyperkalemia by promoting the excretion of potassium through urine. This helps lower the elevated potassium levels in the blood and reduce the risk of complications such as cardiac arrhythmias. Therefore, administering a diuretic is an appropriate intervention for a client with a potassium level of 6.4 mEq/L.

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A nurse is planning care for a client who has COPD with dyspneic episodes. Which of the following interventions should the nurse include?

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