A nurse is providing care to a client who has COPD and is receiving supplemental oxygen. Which of the following findings should the nurse report to the RN immediately?

Speaks in short phrases

Increased sputum production

Use of accessory muscles to breathe

Pulse oximetry reading of 90%

Answer and Explanation

The Correct Answer is C

A.   Speaking in short phrases can indicate increased effort or difficulty in breathing. While it suggests respiratory compromise, it is not an immediate concern unless it worsens or is accompanied by other severe symptoms.
B.   Increased sputum production is common in clients with COPD and can indicate exacerbation or infection. It should be monitored closely but may not require immediate reporting unless it is severe or associated with other concerning symptoms.
C.   This finding indicates increased respiratory effort and potential respiratory distress, which requires prompt attention and intervention.
D.   A pulse oximetry reading of 90% indicates that the client's oxygen saturation is below the normal range but acceptable in client with COPD due to chronic hypoxemia.

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Correct Answer is A

Explanation

A. This statement demonstrates an understanding that consuming yogurt can potentially help reduce the odor associated with gas. Yogurt contains probiotics, which can promote digestive health and possibly reduce the intensity of gas odors. This is a reasonable approach for managing symptoms related to colostomy.
B. Carbonated beverages are not typically recommended for controlling odor related to a colostomy. In fact, carbonated drinks can sometimes increase gas production and may exacerbate gas-related symptoms. Therefore, this statement does not indicate an appropriate understanding of dietary management for a colostomy.
C. Pasta and other starchy foods like rice and bread are generally well-tolerated and can help thicken stool consistency, which may be beneficial for individuals with a colostomy. Therefore, eliminating pasta from the diet is not necessary and does not reflect an accurate understanding of dietary recommendations post-colostomy.
D. Distributing meals evenly throughout the day is generally recommended to promote balanced nutrition and manage digestion. There is no specific requirement that the largest meal must be in the evening. This statement does not directly relate to dietary management specific to colostomy care.

A. Reposition the client at least every 2 hr. B. Keep the head of the bed elevated. C. Keep the client's skin moist. D. Massage the client's bony prominences.

Correct Answer is A

Explanation

A. Repositioning the client regularly is a critical measure to prevent pressure ulcers. This helps relieve pressure on vulnerable areas of the body and improves circulation. Turning the client every 2 hours is a common guideline to prevent prolonged pressure on any one area.
B. Keeping the head of the bed elevated continuously is not recommended as it can increase shear and friction, leading to skin breakdown.
C. Keeping the client's skin moisturized is important for maintaining skin integrity, but excessive moisture can increase the risk of skin breakdown, especially in areas susceptible to pressure ulcers. The nurse should aim to keep the skin clean, dry, and free from excessive moisture to prevent maceration.
D. Massaging bony prominences is not recommended as a preventive measure for pressure ulcers. In fact, massaging these areas can increase the risk of tissue damage due to friction and shearing forces. The focus should be on relieving pressure through proper positioning and support surfaces rather than massage.

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A nurse is providing care to a client who has COPD and is receiving supplemental oxygen. Which of the following findings should the nurse report to the RN immediately?

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