Which of the following interventions would assist a client with ...

[Hungry!]

Which of the following interventions would assist a client with chronic obstructive pulmonary disease (COPD) to improve lung expansion?
 
  1. Instruct in abdominal breathing
   2. Provide oxygen 2 liters nasal cannula
   3. Coach in pursed lip breathing every 2 hours while awake
   4. Deep breathing and coughing every hour

Question 2

A 9-year-old child is in the hospital preparing for major abdominal surgery for a tumor on a kidney. The parents of the child tell the nurse that they don't want the child to receive narcotics for pain postoperatively.
 
  The best response by the nurse is: 1. Okay, I'll tell the doctor not to order any. Are you sure you want to do this?
   2. You do not have a choice of medication. Decisions involving pain relief are up to the health care providers..
   3. The pain for your child will be severe. Can you tell me why you feel this way?
   4. The pain will be severe. Why don't we ask your child about this?

[rleezy04]

Answer to Question 1

1. Instruct in abdominal breathing

Rationale:
Breathing exercises are frequently indicated for clients with COPD. Abdominal breathing improves lung expansion. Providing oxygen 2 liters per nasal cannula will not improve the client's lung expansion. Pursed-lipped breathing helps keep airways open by maintaining positive pressure. Deep breathing and coughing should be done every 2 hours to help keep the airway clear and prevent the pooling of secretions,not to improve lung expansion.

Answer to Question 2

3. The pain for your child will be severe. Can you tell me why you feel this way?

Rationale:
As a client advocate, the nurse would defend the need for effective pain medication by using assertive communication. The nurse tells the parents the truth about pain and then proceeds to explore the parents' objection to the drugs with them. Acceding to the request of the parents is submissive communication and would not be in the best interests of the child. Telling the parents they do not have a choice is aggressive and untrue. Putting the child in the middle of the discussion is a divisive maneuver.

[Hungry!]

Excellent

[Dnite]

Gracias!