A nurse is reinforcing teaching with a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?

A. Start slowly and increase volume over several sessions.

This is the correct choice. For clients having difficulty using an incentive spirometer, starting slowly and gradually increasing the volume over several sessions is an appropriate approach. It allows the client to become familiar with the device and the technique required for effective use. Starting slowly also reduces the risk of discomfort or respiratory distress, allowing the client to build up their lung capacity gradually and achieve optimal results over time.

B. Do regular deep-breathing exercises instead.

Regular deep-breathing exercises are beneficial for improving lung function and respiratory strength. However, using an incentive spirometer serves a specific purpose in promoting deep breathing and lung expansion to prevent atelectasis (lung collapse) and improve respiratory function. While deep-breathing exercises are helpful, they may not provide the same targeted benefits as using an incentive spirometer, especially for clients who are experiencing difficulty with deep breathing or lung expansion.

C. Use another device because this one might be faulty.

This option assumes that the difficulty with the incentive spirometer is due to a fault in the device itself, which may not necessarily be the case. Before considering another device, it's important to ensure that the client is using the current device correctly and receiving proper instruction. If the client continues to have difficulty despite proper technique and instruction, then further assessment of the device may be warranted.

D. Be much more vigorous in increasing increments.

Being much more vigorous in increasing increments is not recommended, as it could lead to discomfort, respiratory distress, or hyperventilation for the client. Increasing the volume too quickly may overwhelm the client and make it more difficult for them to use the incentive spirometer effectively. Gradual progression allows the client to adjust to the device and build up their lung capacity safely and effectively over time.

A. Nausea

While nausea can occur in hypoxia, it is less common compared to other symptoms such as dyspnea (difficulty breathing), confusion, or cyanosis (bluish discoloration of the skin and mucous membranes).

B. Dysphagia

Dysphagia, or difficulty swallowing, is not typically associated with hypoxia. It is more commonly seen in conditions affecting the esophagus or neurological disorders affecting swallowing function.

C. Agitation

Manifestations of hypoxia can vary depending on the severity and duration of oxygen deprivation. Agitation is a common finding in hypoxia, particularly in cases of acute or severe hypoxemia. As the body's oxygen supply becomes compromised, the brain may perceive this as a threat, leading to increased anxiety, restlessness, and agitation as the body attempts to compensate for the lack of oxygen.

D. Warm, dry skin

Warm, dry skin is not a typical finding in hypoxia. Instead, hypoxia may lead to peripheral vasoconstriction and cool, clammy skin as the body attempts to conserve oxygen and maintain core body temperature.