An older adult who has been diagnosed with COPD wants to perform self-care activities. Which instruction should the nurse include in client teaching to help achieve this goal?
Perform all activities of daily living (ADLs) and then rest
Bathe and eat slowly with periodic rest
Walk short distances without oxygen
Bathe right after eating and then rest
The Correct Answer is B
Choice A reason: Performing all activities of daily living (ADLs) and then resting is not a good instruction for the older adult who has COPD, as it can cause fatigue, shortness of breath, and anxiety. The nurse would advise the older adult to pace themselves and prioritize the most important activities, and to take breaks between tasks.
Choice B reason: Bathing and eating slowly with periodic rest is a good instruction for the older adult who has COPD, as it can help conserve energy, prevent dyspnea, and improve digestion. The nurse would advise the older adult to use a shower chair or a handheld showerhead, to avoid hot water or steam, and to use a fan or an open window for ventilation. The nurse would also advise the older adult to eat small, frequent meals, to avoid foods that cause gas or bloating, and to drink fluids between meals rather than with them.
Choice C reason: Walking short distances without oxygen is not a safe instruction for the older adult who has COPD, as it can cause hypoxia, which is a low level of oxygen in the blood. The nurse would advise the older adult to use oxygen therapy as prescribed by their doctor, and to monitor their oxygen saturation with a pulse oximeter. The nurse would also advise the older adult to exercise regularly, but to start slowly and gradually increase the intensity and duration, and to stop if they feel dizzy, chest pain, or severe breathlessness.
Choice D reason: Bathing right after eating and then resting is not a helpful instruction for the older adult who has COPD, as it can cause indigestion, reflux, or aspiration. The nurse would advise the older adult to wait at least an hour after eating before bathing, and to avoid lying down right after eating or bathing. The nurse would also advise the older adult to elevate their head with pillows when resting or sleeping, and to avoid napping during the day.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Awakens with periodic left-foot numbness is an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it may indicate peripheral neuropathy, which is a common complication of diabetes. Peripheral neuropathy is a nerve damage that affects the feet and legs, causing numbness, tingling, pain, or weakness. Peripheral neuropathy can increase the risk of foot ulcers, infections, and amputations. The nurse should educate the older adult about the importance of regular foot care, blood sugar control, and medication adherence.
Choice B reason: Enjoys spicy food more than bland food is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a personal preference that does not affect the blood glucose levels. However, the nurse should advise the older adult to limit the intake of salt, fat, and sugar, and to follow a balanced and nutritious diet that meets their needs and preferences.
Choice C reason: Has difficulty hearing conversations in crowded rooms is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a common age-related change that does not affect the blood glucose levels. However, the nurse should assess the older adult's hearing ability and provide appropriate aids and strategies to enhance their communication and socialization.
Choice D reason: Requires reading glasses at 2.0 strength is not an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar, as it is a common age-related change that does not affect the blood glucose levels. However, the nurse should assess the older adult's vision and provide appropriate aids and strategies to improve their safety and quality of life.
Choice E reason: None of the above is not the correct answer, as there is one choice that is an alteration in sensory function that the nurse should address in the plan of care for stabilizing the blood sugar.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because over-the-counter NSAIDs are not generally harmless, especially for older adults. NSAIDs can cause gastrointestinal bleeding, renal impairment, hypertension, and increased risk of cardiovascular events. Older adults are more susceptible to these adverse effects due to age-related changes in pharmacokinetics and pharmacodynamics, as well as the presence of comorbidities and polypharmacy. Therefore, NSAIDs should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.
Choice B reason: This is correct because stool softeners and laxatives should be used with opioids. Opioids can cause constipation, which can lead to abdominal pain, nausea, vomiting, fecal impaction, and bowel obstruction. Older adults are more prone to constipation due to decreased intestinal motility, reduced fluid intake, and use of other medications that affect bowel function. Therefore, stool softeners and laxatives should be prescribed along with opioids to prevent and treat constipation in older adults.
Choice C reason: This is incorrect because opioids are not less effective in older clients than in younger clients. Opioids are potent analgesics that can relieve moderate to severe pain in older adults. However, opioids can also cause respiratory depression, sedation, confusion, delirium, falls, and dependence. Older adults are more sensitive to these side effects due to altered pharmacokinetics and pharmacodynamics, as well as the presence of cognitive impairment and frailty. Therefore, opioids should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.
Choice D reason: This is incorrect because the dose limit for acetaminophen is not difficult to reach for older adults. Acetaminophen is a safe and effective analgesic for mild to moderate pain in older adults. However, acetaminophen can cause hepatotoxicity, especially at high doses or in combination with other medications that contain acetaminophen. The recommended maximum daily dose of acetaminophen for older adults is 3 grams, which can be easily reached if the patient is not aware of the amount of acetaminophen they are taking. Therefore, acetaminophen should be used with caution and at the lowest effective dose for the shortest duration possible in older adults.
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