A nurse is providing discharge teaching to a client who had an exacerbation of COPD. The client is prescribed a fluticasone by metered-dose inhaler. Which of the following instructions should the nurse include?
Use fluticasone as needed for shortness of breath.
Limit fluid intake to 1 L per day.
Avoid use of pursed-lip breathing.
Obtain a yearly influenza immunization.
The Correct Answer is D
A. Use fluticasone as needed for shortness of breath: Fluticasone is a corticosteroid used for long-term inflammation control in COPD, not for immediate symptom relief. Short-acting bronchodilators like albuterol are used for acute shortness of breath.
B. Limit fluid intake to 1 L per day: COPD clients benefit from adequate hydration (typically 2-3 L per day) to help thin mucus secretions and improve airway clearance. Restricting fluids can lead to thickened secretions and increased respiratory distress.
C. Avoid use of pursed-lip breathing: Pursed-lip breathing is encouraged for COPD clients to help reduce air trapping, improve oxygenation, and promote more effective exhalation. It is an essential technique for managing dyspnea.
D. Obtain a yearly influenza immunization: COPD clients are at higher risk of complications from respiratory infections. An annual influenza vaccine helps reduce the risk of severe illness and exacerbations, making it a crucial part of COPD management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "I will hold my cellphone on the opposite side of the pacemaker.": Cellphones emit electromagnetic signals that can interfere with pacemaker function if held directly over the device. Keeping the phone on the opposite side minimizes the risk of interference and ensures proper pacemaker function.
B. "I can resume physical activity within 2 weeks.": Strenuous physical activity should be avoided for about 4-6 weeks to allow proper healing of the pacemaker site. Early resumption of activity can lead to lead dislodgement or complications.
C. "I need to cover my pacemaker with a dressing when I shower.": After the initial post-procedure period, there is no need to keep the pacemaker site covered while showering. The incision should be kept dry until it fully heals, but a permanent dressing is unnecessary.
D. "I should avoid using a microwave oven.": Modern pacemakers are shielded against microwave interference, making it safe to use a microwave. This is a common misconception, as older pacemakers were more susceptible to electrical interference.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"A"}}
Explanation
Diabetes:
• Weight
• Blood glucose
Pancreatitis:
• None
Hyperthyroidism:
• Heart rate
• T3 level
Rationale:
• Weight: The client has experienced unintended weight loss, which is a common symptom of diabetes due to the body's inability to use glucose effectively, leading to fat and muscle breakdown.
• Heart rate: Tachycardia is a hallmark of hyperthyroidism due to increased metabolic activity and sympathetic nervous system stimulation.
• T3 level: The T3 level is within the normal range but on the higher end, which can still support hyperthyroidism when considered with other clinical findings.
• Blood glucose: An elevated blood glucose level of 250 mg/dL is consistent with diabetes, as normal fasting levels are below 106 mg/dL.
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