What is the most common gastrointestinal complaint made to a health care provider?

Choice A: "Client slept throughout the night" - Good sleep can be an indicator of effective pain management. Pain can disrupt sleep, so if the client is sleeping well, it may suggest that their pain is being effectively managed¹.

Choice B: "Client cooperative during AM care" - If the client is cooperative during care, it may suggest that they are not in significant pain. Uncontrolled pain can make people irritable and uncooperative¹.

Choice C: "Client ate 80% of breakfast, 70% of lunch and 100% of dinner" - Pain can affect appetite. If the client is eating well, it may suggest that their pain is under control¹.

Choice D: "Client winces only when turned and repositioned" - If the client only shows signs of discomfort during movement, it may suggest that their pain is generally well-controlled¹.

Choice E: "Client slept during dressing change" - This is not necessarily an indicator of effective pain management. The client could be sleeping due to fatigue, medication effects, or other reasons unrelated to their pain level¹.

Choice A reason: Avoiding sick people and washing hands is the most important client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, as it can reduce the exposure to respiratory infections, which are the main cause of COPD exacerbations. The nurse would advise the older adult to stay away from people who have colds, flu, or other contagious illnesses, and to wash their hands frequently with soap and water or use alcohol-based hand sanitizer.

Choice B reason: Using low-flow oxygen for dyspnea is a possible client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it depends on the severity of the condition and the oxygen saturation level of the patient. The nurse would advise the older adult to use oxygen therapy as prescribed by their doctor, and to monitor their oxygen level with a pulse oximeter.

Choice C reason: Easing breathing by sitting upright is a helpful client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a supportive measure that does not address the underlying cause of the exacerbation. The nurse would advise the older adult to sit upright or lean forward when they have difficulty breathing, and to use pursed-lip breathing or abdominal breathing techniques.

Choice D reason: Eating nutrient- and calorie-dense foods is a beneficial client teaching for the nurse to include for the prevention of hospitalizations for exacerbations of COPD, but it is not the most important one, as it is a long-term strategy that does not prevent the immediate risk of exacerbation. The nurse would advise the older adult to eat a balanced diet that provides enough protein, carbohydrates, fats, vitamins, and minerals, and to avoid foods that can cause gas, bloating, or reflux.