A nurse is developing a nutritional care plan for a client who has COPD and severe dyspnea.
To promote intake, which of the following actions should the nurse include in the plan of care?
A.
Administer a bronchodilator after meals.
B.
Ambulate the client before each meal.
C.
Limit fluid intake with meals.
D.
Offer the client three large meals each day.
The Correct Answer and Explanation is:
The correct answer is C. Limit fluid intake with meals.
Explanation:
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that makes breathing difficult due to obstructed airflow from the lungs. Severe dyspnea, or shortness of breath, is a common symptom in individuals with COPD, particularly during or after eating, as the act of eating can increase oxygen demand and pressure on the diaphragm, making breathing even more challenging.
When developing a nutritional care plan for a client with COPD and severe dyspnea, it’s important to take steps that minimize discomfort and maximize nutritional intake. Limiting fluid intake with meals is a strategic action because excessive fluids can increase gastric distention, which in turn can push against the diaphragm, making breathing more difficult. By reducing fluid intake during meals, the nurse helps to minimize this discomfort, potentially leading to better food consumption and overall nutritional status.
Why the Other Options Are Less Appropriate:
- A. Administer a bronchodilator after meals: While bronchodilators are essential for managing COPD symptoms, administering them after meals may not be as effective as giving them before meals. Taking a bronchodilator before meals can help open the airways, making it easier for the client to breathe while eating, thereby improving the chances of adequate nutritional intake.
- B. Ambulate the client before each meal: Ambulation is generally beneficial for clients with COPD, as it helps with lung function and circulation. However, immediately before meals, it may tire the client and exacerbate dyspnea, reducing their ability to eat. Energy conservation strategies are typically recommended for clients with severe dyspnea.
- D. Offer the client three large meals each day: Large meals can be overwhelming and cause significant gastric distention, leading to increased pressure on the diaphragm and worsening dyspnea. Instead, smaller, more frequent meals (5-6 small meals a day) are often recommended to avoid overloading the digestive system and to help maintain a steady intake of nutrients without exacerbating breathing difficulties.
In summary, limiting fluid intake with meals is a practical approach in the nutritional care plan for a client with COPD and severe dyspnea, as it helps prevent gastric distention and eases the breathing process, thereby promoting better nutritional intake.