The nurse is caring for a client with a history of chronic kidney disease. Which dietary restriction should the nurse emphasize?

Choice A reason: A numeric pain scale quantifies pain intensity but not its quality, such as burning or stabbing. Descriptive data provide a fuller picture of pain characteristics, which guide treatment. Numbers alone lack the detail needed to assess the nature of the pain experience.

Choice B reason: Observing body language and movement, like grimacing or guarding, indicates pain presence but not its specific quality. Subjective descriptions from the client reveal characteristics like sharpness or throbbing, which are critical for diagnosis and management, making observation secondary to verbal reports.

Choice C reason: Asking the client to describe the pain captures its quality, including type, location, and pattern (e.g., burning, stabbing). This subjective data is essential for diagnosing the pain’s cause and tailoring treatment, as it provides detailed insights beyond intensity or observable signs, making it the best approach.

Choice D reason: Identifying effective pain relief measures is part of pain management, not assessment of pain quality. Understanding the pain’s characteristics through description is necessary before selecting interventions. This approach is premature without first gathering detailed subjective data from the client.

Choice A reason: Obtaining an arterial blood gas assesses oxygenation and acid-base status, useful in COPD management, but is not required before postural drainage. This invasive procedure is unnecessary for routine drainage, which mobilizes secretions. Explaining positions prepares the client, enhancing cooperation and effectiveness.

Choice B reason: Performing drainage after meals risks aspiration or vomiting, as a full stomach increases intra-abdominal pressure in COPD patients. Postural drainage is most effective when performed on an empty stomach, making this approach incorrect. Patient education on positioning is the priority.

Choice C reason: Shallow, fast breathing is counterproductive in COPD, as it reduces tidal volume and worsens hypercapnia. Postural drainage requires slow, deep breaths to mobilize secretions and improve ventilation. Explaining positions ensures proper technique, making this breathing instruction incorrect.

Choice D reason: Explaining that the client may be placed in five positions (e.g., prone, supine, lateral) prepares them for postural drainage, which uses gravity to mobilize lung secretions in COPD. This education enhances compliance and effectiveness, as proper positioning is critical for therapeutic success, making it the correct approach.