A nurse is providing dietary teaching for a client who has chronic obstructive pulmonary disease. Which of the following instructions should the nurse include?
"Use a bronchodilator 1 hour before eating."
"Eat 3 large meals each day."
"Limit water intake with meals."
"Reduce protein intake."
None
None
The Correct Answer is C
A. Administration of a prescribed bronchodilator is typically recommended approximately 30 minutes prior to meals rather than 1 hour. This pharmacological timing helps reduce dyspnea and facilitates easier deglutition and mastication by improving airflow. Using it too early may result in the peak therapeutic effect tapering off before the client finishes the meal.
B. Consuming 3 large meals each day is contraindicated for clients with chronic obstructive pulmonary disease because a distended stomach can exert upward pressure on the diaphragm. This abdominal crowding significantly increases the work of breathing and leads to early satiety or respiratory distress. Clients are instead encouraged to eat 5 to 6 small, frequent, nutrient-dense meals.
C. The nurse should instruct the client to limit water or fluid intake during the actual mealtime to prevent premature gastric distention. Early fullness from fluids reduces the client’s ability to consume essential solid nutrients and calories required to support the increased metabolic demands of labored breathing. Fluids should be consumed between meals to maintain adequate hydration and thin secretions.
D. Reducing protein intake is inappropriate because these clients require high-protein and high-calorie diets to prevent muscle wasting and support the respiratory muscles. The metabolic cost of breathing in chronic obstructive pulmonary disease is significantly elevated, often leading to a state of malnutrition or cachexia. Protein is vital for tissue repair and maintaining the functional integrity of the diaphragm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D"]
Explanation
These responses are correct and explain how albuterol helps the client's breathing. Albuterol is a short- acting beta2-agonist that causes bronchodilation and relieves bronchospasm, which are the main causes of wheezing and dyspnea in clients who have asthma or COPD. By opening the airways, albuterol improves gas exchange and oxygenation.
b) The medication will decrease coughing episodes. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on coughing, which is a reflex response to irritation or obstruction of the airways. Coughing may be beneficial for clearing secretions and mucus from the lungs, but it may also cause bronchoconstriction and inflammation. The nurse should advise the client to use other measures to decrease coughing, such as drinking fluids, using a humidifier, or taking an expectorant.
c) The medication will reduce inflammation. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have an anti-inflammatory effect on the airways, which are often inflamed and swollen in clients who have asthma or COPD. Inflammation can contribute to airway obstruction and mucus production, which impair gas exchange and oxygenation. The nurse should inform the client that albuterol is used for quick relief of acute symptoms, but not for long-term control or prevention of inflammation. The client may need to use another medication, such as an inhaled corticosteroid, to reduce inflammation.
e) The medication will stimulate flow of mucus. This response is incorrect and does not explain how albuterol helps the client's breathing. Albuterol does not have a direct effect on mucus production or clearance, which are often increased in clients who have asthma or COPD. Mucus can cause airway obstruction and infection, which impair gas exchange and oxygenation. The nurse should advise the client to use other measures to stimulate flow of mucus, such as drinking fluids, using a humidifier, or taking an expectorant.
Correct Answer is B
Explanation
This response is empathetic and therapeutic, as it acknowledges the client's feelings and invites her to express her concerns. It also shows respect and interest in the client's perspective.
a) This response is false reassurance and nontherapeutic, as it dismisses the client's feelings and implies
that the surgery will solve everything.
b) This response is self-disclosure and nontherapeutic, as it shifts the focus from the client to the nurse and
does not address the client's fears.
d) This response is minimizing and nontherapeutic, as it tells the client how to feel and does not acknowledge the client's regret or anxiety.
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