The nurse develops a teaching plan to help increase activity tolerance at home for an older adult with severe chronic obstructive pulmonary disease (COPD). Which instructions would be most appropriate for the nurse to include in the plan of care?
a. Stop exercising when short of breath.
b. Walk until pulse rate exceeds 130 beats/minute.
c. Limit exercise to activities of daily living (ADLs).
d. Walk 15 to 20 minutes daily at least 3 times/week.
ANS: D
Encourage the patient to walk 15 to 20 minutes a day at least three times a week with gradual increases. Shortness of breath is normal with exercise and not an indication that the patient should stop. Limiting exercise to ADLs will not improve the patient's exercise tolerance. A 70-year-old patient should have a pulse rate of 120 or less with exercise (80% of the maximal heart rate of 150).
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