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A client with chronic obstructive pulmonary disease (COPD expresses difficulty in bringing up bronchial secretions. Which action should the nurse take to help the client with tenacious bronchial secretions?
- A. Maintaining a semi-Fowler's position as much as possible
- B. Administering oxygen via nasal cannula at 2 L per min
- C. Helping the client select a low-salt diet
- D. Encouraging the client to drink eight glasses of water daily
Correct Answer: D
Rationale: Encouraging the client to drink eight glasses of water daily is the most appropriate action to help with tenacious bronchial secretions in COPD. Increased fluid intake can help in thinning the mucus, making it easier for the client to cough up and clear secretions. This addresses the client's difficulty in bringing up bronchial secretions. Maintaining a semi-Fowler's position can aid in breathing but does not directly address the issue of clearing secretions. Administering oxygen may be necessary for COPD, but it does not specifically target the tenacious secretions. Selecting a low-salt diet can be helpful in managing COPD in general, but it does not directly address the client's current concern of clearing bronchial secretions.
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A client is receiving oxygen therapy via a nasal cannula. The nurse should explain that this method of oxygen delivery does which of the following?
- A. Delivers a specific concentration of oxygen constantly
- B. Delivers a high concentration of oxygen
- C. Delivers a low concentration of oxygen
- D. Restricts the client's ability to eat, speak, or drink
Correct Answer: A
Rationale: A nasal cannula is a device used for delivering supplemental oxygen to patients. It delivers a specific concentration of oxygen constantly, typically ranging from 1-6 liters per minute. This method is effective for patients who require low to moderate levels of oxygen. Choices B and C are incorrect because a nasal cannula does not deliver a high concentration of oxygen and is not considered a low concentration delivery method. Choice D is incorrect because a nasal cannula does not restrict the client's ability to eat, speak, or drink; it allows them to perform these activities while receiving oxygen therapy.
A client with angina pectoris is being taught about starting therapy with nitroglycerin (Nitrostat) tablets. The nurse should instruct the client to take the medication
- A. after each meal and at bedtime.
- B. every 15 minutes during an acute attack.
- C. at the first indication of chest pain.
- D. with 8 oz of water.
Correct Answer: C
Rationale: Nitroglycerin (Nitrostat) tablets are used to relieve chest pain associated with angina. The client should take the medication at the first indication of chest pain to help dilate blood vessels and improve blood flow to the heart muscle. Choice A is incorrect because nitroglycerin should not be scheduled after each meal or at bedtime. Choice B is incorrect as taking the medication every 15 minutes during an acute attack is excessive and not recommended. Choice D is incorrect because while it is important to take nitroglycerin with water, the timing of water intake is not as critical as taking the medication at the first sign of chest pain.
A provider is discharging a client with a prescription for home oxygen therapy. Client and family teaching by the nurse should include all of the following instructions except?
- A. Cleanse the mask or collar with soapy water every other day.
- B. Ensure that the straps on the mask are secure but not too tight.
- C. Apply petroleum jelly around and inside the nares.
- D. Post 'no smoking' warning signs at home in a prominent location.
Correct Answer: C
Rationale: When providing instructions for home oxygen therapy, it is important to ensure safety and proper care. Choices A, B, and D are all essential instructions for the client and family. Choice C, 'Apply petroleum jelly around and inside the nares,' is incorrect. Petroleum jelly should not be used near oxygen sources as it is flammable and can increase the risk of fire hazard. Therefore, this instruction should not be included in the teaching.
A client prescribed home oxygen therapy is receiving discharge teaching from a nurse. Which statement by the client indicates a need for further teaching?
- A. I will be able to tell the amount of oxygen being delivered by looking at the flowmeter.
- B. I should contact my doctor if I notice a decrease in my ability to concentrate.
- C. I will ensure that visitors smoke outside.
- D. I should see a frosty buildup on the tank when I refill my portable oxygen.
Correct Answer: A
Rationale: The correct answer is A. The client's statement indicates a need for further teaching because the flowmeter indicates the flow rate of oxygen, not the total amount of oxygen being delivered. Choices B, C, and D demonstrate understanding of safety measures and indications for seeking medical attention in relation to home oxygen therapy, making them appropriate statements.
A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes?
- A. Pigeon
- B. Funnel
- C. Kyphotic
- D. Barrel
Correct Answer: D
Rationale: When assessing a client with COPD, the nurse should expect the client's chest to be barrel-shaped. This shape is a classic characteristic of COPD due to hyperinflation of the lungs. A 'Pigeon' chest shape is associated with pectus carinatum, a deformity of the chest wall. A 'Funnel' chest shape is seen in conditions like pectus excavatum. 'Kyphotic' refers to an exaggerated outward curvature of the thoracic spine. Therefore, the correct answer is 'Barrel' as it is the expected chest shape in clients with COPD.