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 C
Explanation
Choice A rationale
Advising the client that it is too late to receive an influenza vaccination once symptoms occur is correct, but it does not address the client’s question about oseltamivir.
Choice B rationale
Explaining that antibiotics are not useful in treating viral infections is correct, but it does not address the client’s question about oseltamivir.
Choice C rationale
Referring the client to the healthcare provider to obtain a medication prescription is the most appropriate response. Oseltamivir is an antiviral medication that can be effective if started within 48 hours of symptom onset.
Choice D rationale
Instructing the client that over-the-counter medications are sufficient to manage influenza symptoms is not appropriate, as oseltamivir can help reduce the severity and duration of the illness if taken early.
Correct Answer is A
Explanation
Choice A rationale
Reported history of alcoholism is the most important assessment finding to address before administering terbinafine HCL. Terbinafine is metabolized by the liver, and clients with a history of alcoholism may have impaired liver function, increasing the risk of hepatotoxicity. Monitoring liver function and assessing for signs of liver damage are crucial before starting treatment.
Choice B rationale
Toenails appear thick and yellow is a common symptom of fungal toenail infection, but it is not the most critical assessment finding to address before administering terbinafine HCL. The focus should be on assessing liver function.
Choice C rationale
Employed as a construction worker is not the most critical assessment finding to address before administering terbinafine HCL. While occupational exposure to fungi may be relevant, the primary concern is liver function.
Choice D rationale
White blood cell count of 8,500/mm³ (8.5 x 10⁹/L) is within the normal range and is not the most critical assessment finding to address before administering terbinafine HCL. The primary concern is liver function.