A nurse is teaching a client who is receiving radiation therapy about skin protection. Which of the following client statements indicates an understanding of the teaching?

Rationale:

A. Administer a bronchodilator following meals: Bronchodilators should be administered before meals, not after, to help relieve shortness of breath and improve the client’s ability to eat without fatigue or dyspnea. Giving them afterward does not assist with eating difficulties.

B. Limit the client's food consumption between meals: Restricting food intake between meals would reduce overall caloric intake, which is counterproductive for a client who is underweight and experiencing nutritional deficits due to COPD. Frequent small meals are usually recommended.

C. Arrange for a low-protein diet: Clients with COPD who are underweight often need adequate protein to maintain muscle mass and respiratory function. A low-protein diet could worsen malnutrition and impair recovery.

D. Request non-gas-forming foods from the dietary department: Non-gas-forming foods reduce bloating and abdominal discomfort, which can make eating easier for clients with COPD who experience dyspnea. This intervention supports improved caloric intake and minimizes respiratory compromise during meals.

Rationale:

A. Encourage the client to drink 3000 mL of fluid daily: The client has heart failure with a prescribed fluid restriction of 1000 mL/day. Encouraging excess fluid intake could worsen fluid overload and pulmonary edema, so this is not appropriate.

B. Use soap and water to provide perineal care: Proper perineal hygiene with soap and water reduces the risk of introducing bacteria into the urinary tract, helping prevent catheter-associated urinary tract infections (CAUTIs).

C. Place the drainage bag on the bed when transporting the client: The drainage bag should always be kept below the level of the bladder to prevent backflow and contamination. Placing it on the bed increases the risk of infection and is contraindicated.

D. Change the indwelling urinary catheter tubing every 3 days: Routine changing of the catheter tubing is not recommended as it can increase the risk of infection. Tubing should only be changed if it is compromised, soiled, or obstructed.

E. Empty the drainage bag when it is half-full: Regularly emptying the drainage bag before it becomes overly full prevents backflow and reduces bacterial proliferation, helping to decrease UTI risk.

F. Review the need for the indwelling urinary catheter daily: Assessing the ongoing need for the catheter allows for timely removal, which is the single most effective intervention to prevent catheter-associated urinary tract infections.