A patient with chronic obstructive pulmonary disease (COPD) on daily prednisone therapy has been eating very little and has lost weight. Which interventions are appropriate for the nurse to include in the care plan? Select all that apply.
Offer high-calorie protein snacks between meals and at bedtime.
Encourage increased intake of whole grains and vegetables.
Encourage rest before meals.
Provide a large glass of juice with each meal.
Correct Answer : A,C
Choice A reason: Offering high-calorie protein snacks between meals and at bedtime is appropriate for a patient with COPD who is losing weight and eating very little. These snacks can help meet their nutritional needs and provide the extra calories and protein necessary to prevent muscle wasting and support overall health.
Choice B reason: While increasing the intake of whole grains and vegetables is generally healthy, it may not be the priority for a patient who has lost significant weight and needs to focus on higher-calorie, nutrient-dense foods. The primary goal is to address the calorie and protein deficit first.
Choice C reason: Encouraging rest before meals is beneficial as it helps conserve energy for eating. Patients with COPD often experience fatigue, which can reduce their appetite and ability to eat. Resting before meals can help them feel more energetic and better able to consume their meals.
Choice D reason: Providing a large glass of juice with each meal is not ideal for increasing calorie and protein intake. While juice can provide some calories and nutrients, it is not a good source of protein. Additionally, large volumes of liquid can create a feeling of fullness, reducing the patient's appetite for nutrient-dense foods.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Informing the patient that the pain medication is contraindicated and offering to dim the room lights addresses the immediate concern but does not provide an effective solution for pain management. While it's important to inform the patient, alternative pain relief should be pursued.
Choice B reason: Monitoring the patient closely after administering ibuprofen for pain does not ensure patient safety, especially since ibuprofen can worsen kidney function in patients with acute renal failure. Administering ibuprofen is contraindicated in this case.
Choice C reason: Consulting the healthcare provider about ordering a different pain medication is the safest first step. This ensures that the patient receives an appropriate pain reliever that does not further compromise their renal function. The healthcare provider can prescribe a medication that is safe for patients with acute renal failure.
Choice D reason: Administering ibuprofen as ordered since it is used to treat headaches is not appropriate in this scenario. Ibuprofen is nephrotoxic and can worsen renal function in patients with acute renal failure, making it unsafe to administer.
Correct Answer is C
Explanation
Choice A reason: Teaching the patient to use guided imagery can be an effective pain management strategy, but it might not be the most immediate and reassuring intervention for a patient experiencing fear about postoperative pain. This approach is more useful as an additional technique rather than the primary intervention.
Choice B reason: Describing the type of pain expected with the patient's particular surgery can provide some insight into what to anticipate, but it does not necessarily alleviate fear or provide concrete strategies for managing pain. It might even increase anxiety by focusing on the details of the pain itself.
Choice C reason: Explaining the pain management plan, including the use of a pain rating scale, is the most effective intervention. This approach directly addresses the patient's concerns by providing them with a clear understanding of how their pain will be managed and controlled postoperatively. Knowing that there is a structured plan in place, with specific methods to assess and manage pain, helps build confidence and reduces fear. The use of a pain rating scale also empowers the patient to communicate their pain levels effectively, ensuring timely and appropriate interventions.
Choice D reason: Informing the patient that pain medication will be available is helpful, but it lacks the detail and comprehensive approach of explaining the entire pain management plan. Patients may still have concerns about how their pain will be assessed and addressed specifically.
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