When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?
Explain that the client may be placed in five positions.
Perform the drainage immediately after meals.
Obtain an arterial blood gas (ABG) prior to the procedure.
Instruct the client to breathe shallow and fast.
The Correct Answer is A
Choice A rationale
Postural drainage involves placing the client in various positions to facilitate the drainage of secretions from different parts of the lungs. Typically, the client may be placed in five positions: head down, prone, right and left lateral, and sitting upright.
Choice B rationale
Performing postural drainage immediately after meals is not recommended as it can cause nausea, vomiting, and aspiration. It is best to perform the procedure before meals.
Choice C rationale
Obtaining an arterial blood gas (ABG) prior to the procedure is not a standard requirement for postural drainage. ABGs are typically obtained to assess the client’s respiratory status but are not necessary for the procedure itself.
Choice D rationale
Instructing the client to breathe shallow and fast is not appropriate for postural drainage. The client should be encouraged to breathe slowly and deeply to help keep the airways open and facilitate the drainage of secretions.
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Correct Answer is A
Explanation
Choice A rationale
Isoniazid is an antitubercular drug used to treat active tuberculosis. The effectiveness of this medication is evaluated by observing a decrease in symptoms such as cough and sputum production. This indicates that the infection is being controlled and the bacteria are being eradicated.
Choice B rationale
A positive sputum smear and culture would indicate the presence of active tuberculosis bacteria, suggesting that the treatment is not effective. Therefore, this is not an expected outcome of effective treatment.
Choice C rationale
Decreased appetite and weight loss are not indicators of the effectiveness of tuberculosis treatment. In fact, these symptoms could indicate a worsening of the condition or side effects of the medication.
Choice D rationale
Vertigo and tinnitus are not related to the effectiveness of tuberculosis treatment. These symptoms could be side effects of the medication but do not indicate the success of the treatment.
Correct Answer is C
Explanation
Choice A rationale
Securing tracheostomy ties by making knots close to the tube can cause irritation and pressure on the skin.
Choice B rationale
Removing ties to secure a disposable, soft foam collar with hook and loop fastener is not the most important action when changing the ties of the tracheostomy tube.
Choice C rationale
Leaving the old ties in place until the new ones are secure is the most important action to prevent accidental dislodgement of the tracheostomy tube.
Choice D rationale
Placing knots of the ties laterally to prevent irritation and pressure is important but not the most critical action when changing the ties of the tracheostomy tube.