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 B
Explanation
Choice A rationale
An increase in B-lymphocytes and IgM is not how HIV suppresses the immune system. B-lymphocytes are responsible for producing antibodies, and IgM is a type of antibody. HIV primarily affects T-lymphocytes, specifically helper T-cells (CD4 cells), rather than B-lymphocytes.
Choice B rationale
The destruction of helper T-cells and CD4 cells is the primary mechanism by which HIV suppresses the immune system. HIV targets and infects these cells, leading to their depletion. Helper T-cells play a crucial role in coordinating the immune response, and their loss results in a weakened immune system, making the body more susceptible to infections and diseases.
Choice C rationale
A deficiency of cytotoxic T cells is not the primary mechanism by which HIV suppresses the immune system. Cytotoxic T cells (CD8 cells) are involved in directly killing infected cells, but the main impact of HIV is on helper T-cells (CD4 cells), which are essential for orchestrating the immune response.
Choice D rationale
The proliferation of suppressor T-cells is not how HIV suppresses the immune system. Suppressor T-cells (regulatory T cells) help regulate and control the immune response, but HIV primarily affects helper T-cells (CD4 cells), leading to their destruction and a weakened immune system.
Correct Answer is C
Explanation
Choice A rationale
Topical antifungals are used to treat fungal infections and are not effective for psoriasis, which is an autoimmune condition.
Choice B rationale
Colloidal oatmeal-based lotion can help soothe the skin but does not address the underlying inflammation and scaling associated with psoriasis.
Choice C rationale
Topical corticosteroids are the mainstay of treatment for psoriasis. They help reduce inflammation, itching, and redness associated with psoriatic plaques.
Choice D rationale
Topical analgesics can help relieve pain but do not address the underlying inflammation and scaling associated with psoriasis.