A nurse is caring for a client who has COPD. Which of the following actions should the nurse take?
A.
Encourage the client to drink 8 glasses of water a day.
B.
Instruct the client to cough every 4 hr.
C.
Provide the client with a low protein diet.
D.
Advise the client to lie down after eating
The Correct answer and Explanation is:
Correct Answer: A. Encourage the client to drink 8 glasses of water a day.
Explanation:
Chronic obstructive pulmonary disease (COPD) is a progressive lung condition characterized by chronic airflow limitation, which is not fully reversible. The primary diseases under the umbrella of COPD are chronic bronchitis and emphysema. Patients with COPD often experience symptoms such as shortness of breath, chronic cough, sputum production, and frequent respiratory infections. These symptoms can significantly impact the patient’s quality of life and daily functioning.
Encouraging Hydration (Answer A): One of the key nursing interventions for clients with COPD is ensuring adequate hydration. Drinking plenty of fluids, particularly water, helps thin the mucus in the airways, making it easier for the client to cough it up. This is important because mucus accumulation in the airways can lead to obstruction, worsening breathing difficulties and increasing the risk of infections. The recommended intake of 8 glasses of water a day is appropriate unless contraindicated due to other medical conditions such as heart failure. It is also advisable for clients to avoid caffeine and alcohol, as these can have dehydrating effects.
Instructing to Cough Every 4 Hours (Answer B): Although encouraging coughing is an essential part of managing COPD, instructing the client to cough every four hours is not the best approach. Clients with COPD should use controlled coughing techniques, especially during times of increased mucus production, rather than being on a strict schedule. The nurse should teach the client how to perform effective coughing and deep breathing exercises as needed, particularly when mucus is present.
Diet Considerations (Answer C): Clients with COPD often require a diet high in calories and protein, especially if they are underweight or have increased energy needs due to the extra effort of breathing. A low-protein diet would be inappropriate, as it could lead to muscle wasting and reduced respiratory muscle strength, further compromising breathing.
Advising to Lie Down After Eating (Answer D): Advising a client with COPD to lie down after eating could exacerbate breathing difficulties. After meals, it is advisable for these clients to remain in an upright position, as lying down can increase the risk of aspiration and contribute to gastroesophageal reflux, which can worsen respiratory symptoms.
In summary, encouraging the client with COPD to drink 8 glasses of water a day (Answer A) is the most appropriate action as it directly addresses a key aspect of COPD management by helping to thin mucus and promote effective airway clearance.