A nurse is reinforcing teaching with the parents of a child who is starting to use a spacer with a metered-dose inhaler (MDI) to treat asthma. Which of the following information should the nurse include in the teaching?

A. Offer small frequent meals

Offering small, frequent meals is beneficial for patients with COPD because it helps overcome the challenges associated with dyspnea and fatigue. Large meals can cause discomfort and increase the effort required for breathing, which can exacerbate respiratory symptoms. By providing smaller, more manageable portions of food throughout the day, patients with COPD can maintain their energy levels and meet their nutritional needs without experiencing excessive respiratory distress.

B. Encourage extra liquids with meals

Encouraging extra liquids with meals can help prevent dehydration and thin respiratory secretions, making it easier for patients with COPD to manage their respiratory symptoms. However, excessive fluid intake can also lead to feelings of fullness and discomfort, especially in patients with compromised lung function. Therefore, while it's important to encourage adequate hydration, particularly during meals, it's also essential to balance fluid intake to avoid exacerbating respiratory symptoms.

C. Assist the patient to exercise before meals

While regular exercise is beneficial for overall health and can help improve respiratory function in patients with COPD, exercising immediately before meals may not be practical or advisable for all patients. Patients with COPD may experience fatigue and dyspnea during physical activity, which can affect their ability to eat and digest food effectively. Additionally, exercising before meals may increase energy expenditure and exacerbate respiratory symptoms, making it more challenging for patients to consume an adequate amount of nutrients. Instead, patients with COPD may benefit from engaging in light physical activity or respiratory exercises at a different time of day to improve their respiratory function and overall well-being.

D. Supply information about nutrition

Providing information about nutrition is essential for patients with COPD to help them make healthy dietary choices and manage their condition effectively. However, simply supplying information may not be sufficient to enhance the nutritional status of patients with COPD. It's important to offer practical guidance and support, such as meal planning tips, dietary modifications, and strategies for overcoming barriers to healthy eating. Additionally, individualized dietary counseling from a registered dietitian can be beneficial for patients with COPD to address specific nutritional needs and preferences.

A. "You should inhale through your nose and exhale through your mouth during purse-lipped breathing."

Pursed-lip breathing is a breathing technique commonly used by individuals with COPD to help improve breathing efficiency and manage dyspnea (shortness of breath). During purse-lip breathing, the individual inhales slowly through the nose and exhales slowly and gently through pursed lips, creating a slight resistance to the airflow. This technique helps to keep the airways open longer during exhalation, reduces air trapping, and improves oxygenation.

B. "Your inspiration should be longer than expiration during purse-lipped breathing."

Pursed-lip breathing typically involves making both the inspiration and expiration longer than usual. The focus is on slowing down the breathing rate and extending the exhalation phase to promote better gas exchange and reduce respiratory effort.

C. "You should cough forcefully during exhalation when you are purse-lipped breathing."

Pursed-lip breathing is a gentle breathing technique used to promote relaxation and control of breathing. Forceful coughing during exhalation is not part of purse-lip breathing and may not be appropriate, especially for individuals with COPD who are prone to airway irritation and bronchospasm.

D. "You should be flat on your back when you perform purse-lipped breathing."

The position for performing purse-lip breathing is not specific to lying flat on the back. Individuals can perform purse-lip breathing in various positions that are comfortable and allow for effective breathing, such as sitting upright or leaning slightly forward. The key is to find a position that facilitates relaxation and optimal lung expansion.