Author Question: A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, I wish I were ... (Read 139 times)

cherise1989 · **on:** Jun 25, 2018

A patient with severe chronic obstructive pulmonary disease (COPD) tells the nurse, I wish I were dead I'm just a burden on everybody. Based on this information, which nursing diagnosis is most appropriate?

a. Complicated grieving related to expectation of death
b. Ineffective coping related to unknown outcome of illness
c. Deficient knowledge related to lack of education about COPD
d. Chronic low self-esteem related to increased physical dependence

Question 2

The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD). Which instructions would be most appropriate for the nurse to include in the plan of care?

a. Stop exercising when short of breath.
b. Walk until pulse rate exceeds 130 beats/minute.
c. Limit exercise to activities of daily living (ADLs).
d. Walk 15 to 20 minutes daily at least 3 times/week.

cat123 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
The patient's statement about not being able to do anything for himself or herself supports this diagnosis. Although deficient knowledge, complicated grieving, and ineffective coping may also be appropriate diagnoses for patients with COPD, the data for this patient do not support these diagnoses.

Answer to Question 2

ANS: D
Encourage the patient to walk 15 to 20 minutes a day at least three times a week with gradual increases. Shortness of breath is normal with exercise and not an indication that the patient should stop. Limiting exercise to ADLs will not improve the patient's exercise tolerance. A 70-year-old patient should have a pulse rate of 120 or less with exercise (80 of the maximal heart rate of 150).