The nurse is teaching a client with chronic airflow limitation ...

[DyllonKazuo]

The nurse is teaching a client with chronic airflow limitation (CAL) about positions that help breathing during dyspneic episodes.
 
  Which position, assumed by the client, would indicate that the client needs additional teaching regarding positioning? 1. Sitting up and leaning on a table
  2. Standing and leaning against a wall
  3. Sitting up with elbows resting on knees
  4. Lying on his or her back in a low Fowler's position

Question 2

When participating in the planning of care of a postpartum client who plans to breast-feed her infant, the nurse realizes the importance of including which of the following in the teaching plan to prevent the development of mastitis?
 
  1. Offer only one breast at each feeding.
  2. Massage distended areas as the infant nurses.
  3. Cleanse nipples with a mild antibacterial soap before and after infant feedings.
  4. Express and discard milk from the affected breast at the first signs of mastitis.

[mochi09]

Answer to Question 1

4

Rationale: The client should use the positions outlined in sitting up and leaning on a table, standing and leaning against a wall, and sitting up with elbows resting on knees. These allow for maximal chest expansion and decreased use of accessory muscles of respiration. The client should not lie on his or her back because it reduces movement of a large area of the client's chest wall. Sitting is better than standing, whenever possible. If no chair is available, then leaning against a wall while standing allows accessory muscles to be used for breathing rather than posture control.

Answer to Question 2

2

Rationale: Massaging the distended areas as the infant nurses will encourage complete emptying of the breast and prevent milk stasis. Soap should not be used on the nipples because of the risk of drying or cracking. Each breast should be offered at each feeding to prevent milk stasis and to ensure adequate milk supply. If early signs of mastitis occur, the client usually will be instructed to nurse the infant more frequently, because infant sucking is thought to empty the breast more completely.

[DyllonKazuo]

Excellent

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