A nurse is developing a plan of care for a client who has COPD. The nurse should include which of the
following interventions in the plan?
A Provide the client with a low protein diet.
B Instruct the client to use pursed-lip breathing.
C Restrict the client’s fluid intake to less than 2 L/day.
D Have the client use the early-morning hours for exercise and activity.
The Correct answer and Explanation is:
The correct answer is B: Instruct the client to use pursed-lip breathing.
Explanation:
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by chronic airflow limitation and breathing difficulties. Effective management of COPD involves a combination of pharmacologic treatments, lifestyle modifications, and specific breathing techniques to improve respiratory function and quality of life. Among these techniques, pursed-lip breathing is a critical intervention in managing COPD.
Pursed-lip breathing is a technique where the patient inhales slowly through the nose and exhales through tightly pursed lips. This method helps to maintain open airways by creating a back-pressure that prevents airway collapse, particularly during expiration. By prolonging expiration and reducing the work of breathing, pursed-lip breathing improves ventilation, reduces air trapping, and enhances oxygenation. This technique is beneficial for patients with COPD as it helps to manage dyspnea (shortness of breath) and improves overall respiratory efficiency.
A: Provide the client with a low protein diet. This option is incorrect because a low-protein diet is not appropriate for COPD patients. In fact, protein is crucial for maintaining muscle mass, including respiratory muscles, which are often compromised in COPD. Adequate nutrition, including sufficient protein intake, is essential for the overall health and strength of COPD patients.
C: Restrict the client’s fluid intake to less than 2 L/day. This option is also incorrect. In general, fluid intake is not restricted in COPD unless there is a specific condition like right-sided heart failure where fluid retention is a concern. Adequate hydration is important for thinning mucus and facilitating its expectoration, which helps in managing COPD symptoms.
D: Have the client use the early-morning hours for exercise and activity. This option is not typically recommended as a general guideline for all COPD patients. Exercise is indeed important, but the timing of physical activity should be individualized based on the patient’s symptoms and energy levels. Early mornings might not be suitable for all patients due to increased respiratory symptoms upon waking or other factors.
Overall, pursed-lip breathing is a practical, non-pharmacologic strategy that can significantly improve the quality of life for COPD patients by easing breathing difficulties and enhancing respiratory function.