An older adult male client tells the nurse of losing sleep because of having to get up several times at night to go to the bathroom. The client also reports having trouble starting his urinary stream, and he does not feel like his bladder is ever completely empty. Which intervention should the nurse implement?

Choice A reason: Drawing air in through the nose and exhaling slowly through pursed lips is a technique known as pursed-lip breathing. This method helps improve gas exchange by keeping the airways open longer during exhalation, which aids in the removal of trapped air and reduces dyspneal.

Choice B reason: Increasing the breathing rate for a full 30 seconds is not recommended for clients with emphysema. Rapid breathing can lead to hyperventilation and increased work of breathing, which can exacerbate dyspneal.

Choice C reason: Raising hands above the head to expand the diaphragm might help in some situations, but it is not as effective as pursed-lip breathing for improving gas exchange and reducing dyspneal in clients with emphysema.

Choice D reason: Laying down on each side with knees bent and breathing from the abdomen is a relaxation technique that can help some clients, but it does not specifically address the need for improved gas exchange during episodes of dyspneal.

Choice A reason: Placing the client in a darkened room may help alleviate symptoms if the headache is related to migraine or sensitivity to light, but it does not address the potential underlying cause of the severe headache and blurred vision in a client with a history of diabetes and hypertension.

Choice B reason: Obtaining a blood pressure reading is the most critical first step. Severe headache and blurred vision can be symptoms of hypertensive crisis, which is a medical emergency that requires immediate attention to prevent complications such as stroke or organ damage. Checking the blood pressure will help determine if the client's symptoms are due to elevated blood pressure.

Choice C reason: Administering an oral analgesic may provide temporary relief for the headache, but it does not address the potential underlying causes of the symptoms. The priority is to assess and manage any potentially life-threatening conditions.

Choice D reason: Performing a finger stick glucose test is important for monitoring blood glucose levels in a client with diabetes. However, in the context of the severe headache and blurred vision, the immediate concern should be to rule out hypertensive crisis by checking the blood pressure first. Blood glucose can be checked after ensuring the client's blood pressure is not critically high.