A client, diagnosed with chronic obstructive lung disease ...

[bio_gurl]

A client, diagnosed with chronic obstructive lung disease receiving oxygen at 1.5 liters per minute via nasal cannula, is complaining of shortness of breath. What action should the nurse take?
 
  1. Increase the oxygen to 3 liters per minute via nasal cannula.
  2. Lower the head of the client's bed to semi-Fowler's position.
  3. Have the client breathe through pursed lips.
  4. Encourage the client to breathe more rapidly.

Question 2

The client complains of difficulty breathing. Which of the following assessment findings would the nurse commonly associate with that complaint? (Select all that apply.)
 
  1. Use of accessory muscles
  2. Increased respiratory depth
  3. Increased respiratory rate
  4. Decreased respiratory depth
  5. Decreased respiratory rate

[frejo]

Answer to Question 1

Correct Answer: 3
Rationale 1: In the client with chronic obstructive lung disease, the drive to breathe is often dependent upon low oxygen concentration. Increasing oxygen delivery by increasing the oxygen from 1.5 Lpm to 3 Lpm may be dangerous to this client.
Rationale 2: Lowering the head of the bed makes it more difficult to breathe. This client should have the head of the bed elevated to Fowler's position or should be assisted to lean over the overbed table to increase chest excursion.
Rationale 3: The client should be taught to breathe out against pursed lips to increase the time it takes to exhale and to help keep airways open.
Rationale 4: Chronic obstructive lung disease makes it difficult for the client to breathe out, so increasing rate of respirations will not be helpful.

Answer to Question 2

Correct Answer: 1,2,3,4
Rationale: Rate, depth, and use of accessory muscles often are assessment findings indicating difficulty breathing. The depth of respirations can be deeper (tidal volume greater than 500 mL of air) or more shallow if partial obstruction is present in conditions such as asthma. Rate is generally increased.