A nurse is providing teaching to a client who is scheduled for a bone marrow biopsy taken from the iliac crest. Which of the following information should the nurse include?

Choice A Reason

Request a prescription for an antibiotic. This intervention is not typically included in the standard care plan for all COPD patients. Antibiotics are generally reserved for cases of acute exacerbations of COPD (AECOPD) with signs of bacterial infection, such as increased dyspnea, increased sputum purulence, and increased sputum volume. Routine use of antibiotics without these signs is not recommended.

Choice B Reason

Educate the client on pursed-lip breathing. This is the correct intervention. Pursed-lip breathing is a technique that helps improve ventilation, release trapped air in the lungs, and reduce the work of breathing. It is particularly beneficial for patients with COPD as it helps them manage shortness of breath and improve their breathing efficiency.

Choice C Reason

Place the client on airborne precautions. This intervention is incorrect. COPD is not an infectious disease that requires airborne precautions. Airborne precautions are used for diseases that are transmitted through the air, such as tuberculosis. COPD management focuses on improving lung function and preventing exacerbations.

Choice D Reason

Initiate oxygen therapy for SpO₂ of 92%. This intervention is partially correct but needs clarification. Oxygen therapy is typically initiated for COPD patients with chronic hypoxemia, usually when SpO₂ is less than 88-90%. An SpO₂ of 92% may not necessarily require oxygen therapy unless the patient is experiencing significant symptoms or has other comorbid conditions.

Choice A Reason

“Your provider will use stool from your digital rectal examination to perform the test.” This statement is incorrect. For fecal occult blood testing, stool samples are typically collected at home using a special kit provided by the healthcare provider. The samples are then sent to a lab for analysis. Using stool from a digital rectal examination is not the standard procedure for FOBT.

Choice B Reason

“Your provider will prescribe a stimulant laxative prior to the procedure to evacuate the bowel.” This statement is incorrect. Stimulant laxatives are not typically prescribed before an FOBT. The test requires a small sample of stool, and using a laxative could interfere with the results. Patients are usually advised to follow specific dietary and medication guidelines to avoid false positives or negatives.

Choice C Reason

“You should begin annual fecal occult blood testing for colorectal cancer screening at 40 years old.” This statement is incorrect. Current guidelines recommend starting colorectal cancer screening, including FOBT, at age 45 for individuals at average risk. Screening may start earlier for those with a higher risk, such as a family history of colorectal cancer.

Choice D Reason

“You should avoid taking corticosteroids prior to testing.” This is the correct statement. Corticosteroids can cause gastrointestinal irritation and bleeding, which may lead to false-positive results in fecal occult blood tests. Therefore, it is important to avoid these medications before testing.