The nurse is assessing the effectiveness of interventions ...

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The nurse is assessing the effectiveness of interventions provided to a client with chronic obstructive pulmonary disease (COPD). Evidence that care has been effective would be:
 
  1. Client leaves hospital unit to smoke outside 4 times a day.
   2. Client needs assistance with morning care and meals due to shortness of breath.
   3. Client states family members would prefer he was admitted to a nursing home for continuing care.
   4. Client conducts morning care and ambulates in room while maintaining an oxygen saturation of 92 on room air per oximetry reading.

Question 2

A client has difficulty understanding the dressing changes that need to be completed in the home after discharge.
 
  The client asks the nurse to demonstrate the procedure again and allow the client's adult child to perform the procedure while the nurse watches. The result of this assertive request will result in: 1. Less compassionate care for the client due to the child's irritation by the request.
   2. A guarantee that the adult child will change the dressings correctly.
   3. A greater likelihood that the wound will heal appropriately.
   4. A slightly increased chance that the wound will become infected due to exposure during dressing changes.

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Answer to Question 1

4. Client conducts morning care and ambulates in room while maintaining an oxygen saturation of 92 on room air per oximetry reading.

Rationale:
Evidence that interventions provided to a client with COPD were successful would be the client conducting morning care and ambulating in the room while maintaining an oxygen saturation of 92. This outcome identifies the client's ability to maintain adequate oxygenation and perform activities of daily living. The client leaving the unit to smoke suggests that the interventions were ineffective. The client who needs assistance with morning care and meals because of shortness of breath needs additional interventions. The client who states that his family would prefer he go to a nursing home may or may not have been positively affected by the interventions; not enough information is provided to know.

Answer to Question 2

3. A greater likelihood that the wound will heal more quickly.

Rationale:
The client used assertive communication to ensure that the dressing changes would be performed correctly, which will likely result in appropriate healing of the client's wound. No information is provided about the adult child's response to the request. There is no guarantee that the child will always perform the task correctly as humans make mistakes. Infection of a wound that is dressed correctly is not the likely result of the care.

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Excellent

[chereeb]

Gracias!