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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Free Nursing Study Resources

Correct Answer is A

Explanation

A) Request return instructions in the client's own words:
Asking the client to repeat instructions in their own words is an effective strategy for ensuring understanding, especially for individuals with low health literacy. This technique, known as the "teach-back" method, allows the nurse to assess the client’s comprehension and clarify any misunderstandings.

B) Provide brochures that reflect a seventh-grade reading level:
While providing materials at a lower reading level can be helpful, it may not be sufficient for individuals with very low health literacy. It is essential to use multiple strategies, including verbal communication and interactive methods, to ensure understanding.

C) Limit teaching materials to written information:
Relying solely on written information is not advisable for clients with low health literacy. Visual aids, demonstrations, and verbal explanations should be included to enhance comprehension and retention of information.

D) Avoid repetition of information within each session:
Repetition is actually beneficial for clients with low health literacy. Repeating key information helps reinforce learning and ensures that the client retains the essential points discussed during the teaching sessions.

A. "If you experience angina, take a 10-minute rest period, then resume exercise." B. "Stop exercising if your heart rate increases by 20 beats per minute from baseline." C. "Limit your exercise to an indoor facility to avoid exposure to the sun." D. "Begin by walking half a mile two times a day for the first week."

Correct Answer is D

Explanation

A) "If you experience angina, take a 10-minute rest period, then resume exercise."
It's important for clients to stop exercising immediately and consult a healthcare provider if they experience angina during exercise. Resting and then resuming exercise can be unsafe without medical advice, as angina indicates insufficient blood flow to the heart.

B) "Stop exercising if your heart rate increases by 20 beats per minute from baseline."
An increase in heart rate during exercise is expected, and stopping at a 20 BPM increase may be overly cautious. Clients should be taught to monitor for excessive fatigue or symptoms like dizziness, but a 20 BPM increase alone isn't necessarily a concern.

C) "Limit your exercise to an indoor facility to avoid exposure to the sun."
While excessive sun exposure can be a concern for some individuals, limiting exercise to indoors is unnecessary unless there are specific contraindications. Clients should be encouraged to exercise in environments they enjoy, with appropriate sun protection if outdoors.

D) "Begin by walking half a mile two times a day for the first week."
This recommendation is a reasonable starting point for postoperative exercise. Walking is a low-impact exercise that can help improve cardiovascular health gradually. Clients should gradually increase their activity level based on their tolerance and healthcare provider's advice.

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