A nurse is teaching a client who has left-sided weakness how to use a quad cane. Which of the following client actions indicates an understanding of the teaching?

Choice A reason: Administering oxygen at 2 L/min is appropriate for clients with emphysema who have hypoxemia. Oxygen therapy should be titrated based on the client's oxygen saturation levels to avoid suppressing the respiratory drive.

Choice B reason: The use of incentive spirometry is beneficial for clients with emphysema as it encourages deep breathing and helps prevent atelectasis. It is an appropriate intervention to include in the plan of care.

Choice C reason: Breathing exercises for clients with emphysema typically focus on prolonging the exhalation phase, not the inhalation phase, to improve airway clearance and reduce the work of breathing.

Choice D reason: Limiting fluid intake is not generally recommended for clients with emphysema unless there are specific contraindications. Adequate hydration can help thin secretions and improve mucus clearance.

Choice A reason: The statement that "the spacer should make a whistling sound as you inhale" is not accurate. A whistling sound from the spacer may indicate that the air is being inhaled too quickly and that the user needs to slow down. The purpose of the spacer is to hold the medication released from the inhaler so that it can be inhaled more easily and effectively into the lungs, not to produce a whistling sound.

Choice B reason: Holding one's breath for 10 seconds after inhaling the medication allows for better deposition of the medication in the lungs. This pause gives the medication time to settle in the airways rather than being exhaled too quickly. It is a recommended practice to maximize the effectiveness of the inhaled medication.

Choice C reason: Cleaning the spacer is important to ensure that it works correctly and is free of any residue or debris that could obstruct the medication's path. However, the instruction to "clean the spacer daily with cold water" is incomplete. After rinsing with cold water, the spacer should be left to air dry without rinsing or wiping, as this can create static that affects medication delivery.

Choice D reason: Waiting 30 seconds between puffs is recommended to allow the user to breathe normally for a short period and to prepare for the next dose of medication. This time interval helps to ensure that the second puff is not rushed and that the medication from the first puff has had time to act.