A nurse teaches a client who has chronic obstructive pulmonary ...

[burton19126]

A nurse teaches a client who has chronic obstructive pulmonary disease. Which statements related to nutrition should the nurse include in this client's teaching? (Select all that apply.)
 
  a. Avoid drinking fluids just before and during meals.
  b. Rest before meals if you have dyspnea.
  c. Have about six small meals a day.
  d. Eat high-fiber foods to promote gastric emptying.
  e. Increase carbohydrate intake for energy.

Question 2

A nurse assesses a client who has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? (Select all that apply.)
 
  a. Production of pink sputum
  b. Tracheal deviation
  c. Pain at insertion site
  d. Sudden onset of shortness of breath
  e. Drainage greater than 70 mL/hr
  f.
  Disconnection at Y site

[Hikerman221]

Answer to Question 1

ANS: A, B, C
Fluids can make a client feel bloated and should be avoided with meals. Resting before the meal will help a client with dyspnea. Six small meals a day also will help to decrease bloating. Fibrous foods can produce gas, which can cause abdominal bloating and can increase shortness of breath. The client should increase calorie and protein intake to prevent malnourishment. The client should not increase carbohydrate intake as this will increase carbon dioxide production and increase the client's risk of for acidosis.

Answer to Question 2

ANS: B, D, E, F
Immediate intervention is warranted if the client has tracheal deviation because this could indicate a tension pneumothorax. Sudden shortness of breath could indicate dislodgment of the tube, occlusion of the tube, or pneumothorax. Drainage greater than 70 mL/hr could indicate hemorrhage. Disconnection at the Y site could result in air entering the tubing. Production of pink sputum, oxygen saturation less than 95, and pain at the insertion site are not signs/symptoms that would require immediate intervention.

[burton19126]

Excellent

[bblaney]

TYSM