A nurse is reinforcing teaching for a client who was admitted with an exacerbation of COPD. Which of the following should the nurse include in the client teaching?

"You should consume small, frequent meals each day."

"You should decrease your caloric intake by 200 calories per day."

"You should increase your oxygen to 5 liters per minute if you have shortness of breath."

"You should discontinue your prednisone when your symptoms improve."

Answer and Explanation

The Correct Answer is A

Choice A Reason;
"You should consume small, frequent meals each day." This statement is advisable for COPD management. Eating smaller, more frequent meals can help prevent bloating or feeling overly full, which might interfere with breathing due to increased pressure on the diaphragm.
Choice B Reason:
"You should decrease your caloric intake by 200 calories per day." While maintaining a healthy weight is important for COPD management, reducing caloric intake without specific guidance or assessment might not be suitable. It's crucial to consult with a healthcare provider or dietitian for individualized dietary recommendations.
Choice C Reason:
"You should increase your oxygen to 5 liters per minute if you have shortness of breath." Adjusting oxygen flow should be done based on a healthcare provider's prescribed guidelines. Self-adjustment of oxygen flow without medical advice can be risky and might not address the underlying cause of shortness of breath during a COPD exacerbation.
Choice D Reason:
"You should discontinue your prednisone when your symptoms improve." Prednisone or other corticosteroids are often prescribed during a COPD exacerbation to reduce inflammation in the airways. However, discontinuing corticosteroids abruptly without a healthcare provider's guidance can lead to a recurrence of symptoms or potential complications. It's important to follow the prescribed regimen and complete the course as directed.

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Correct Answer is C

Explanation

Choice A Reason:

Administer meperidine IM is incorrect. Reason why it's not the answer: Meperidine (Demerol) is not recommended in cases of malignant hyperthermia. It can potentially exacerbate the situation by further increasing muscle rigidity and potentially contributing to the hypermetabolic state. Meperidine can trigger additional release of calcium from the sarcoplasmic reticulum in muscles, worsening the symptoms.

Choice B Reason:

Instill a warm enema solution is incorrect. Reason why it's not the answer: Introducing warm solutions can exacerbate the client's condition by further increasing body temperature. Malignant hyperthermia is characterized by a dangerous increase in body temperature, and adding heat through an enema would only make the situation worse.

Choice C Reason:

Applying a cooling blanket is recommendable. Reason why it's the answer: A cooling blanket is a recommended intervention for managing malignant hyperthermia. Lowering the body temperature is crucial in preventing further complications associated with the high fever. Cooling blankets help dissipate heat from the body, aiding in rapidly reducing the dangerously elevated temperature associated with malignant hyperthermia.

Choice D Reason:

Ventilate client with 50% oxygen is incorrect. Reason why it's not the answer: While providing oxygen support might be necessary as part of managing the overall condition, ventilating with 50% oxygen specifically may not directly address the core issue of rapidly cooling the body during a malignant hyperthermia crisis. Ventilation may be required, but the immediate concern is to cool the body to prevent complications arising from the elevated body temperature.

A. Prepare the sterile dressing supplies 30 min before the dressing change. B. Don sterile gloves before removing the dressing, C. Disinfect the wound bed with alcohol before applying tape. D. Offer the client pain medication before the procedure.

Correct Answer is D

Explanation

Choice A Reason:
Preparing the sterile dressing supplies 30 min before the dressing change is correct. While it's crucial to have all supplies ready before starting the procedure, preparing them 30 minutes in advance might not align with the principles of maintaining sterility. It's generally best to prepare sterile supplies just before the procedure to minimize the risk of contamination.
Choice B Reason:
Don sterile gloves before removing the dressing is incorrect. Sterile gloves should indeed be worn during the dressing change, but they should be put on after removing the old dressing. This ensures that the clean gloves don't touch potentially contaminated surfaces during the removal of the old dressing.
Choice C Reason:
Disinfect the wound bed with alcohol before applying tape is incorrect. Using alcohol to disinfect the wound bed is not recommended as it can cause tissue irritation and delay wound healing. Sterile saline or another wound cleansing solution prescribed for wound care would be more appropriate to clean the wound bed. Additionally, applying tape directly to the wound is generally avoided to prevent further damage to the fragile tissues of a pressure ulcer.
Choice D Reason:
Offering the client pain medication before the procedure is correct. Providing pain medication before the procedure ensures the client's comfort and helps manage any discomfort or pain associated with the dressing change, particularly when dealing with a stage III pressure ulcer, which can be quite sensitive.

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A nurse is reinforcing teaching for a client who was admitted with an exacerbation of COPD. Which of the following should the nurse include in the client teaching?

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