Mr. M is a frail 82-year-old client hospitalized for an acute exacerbation of COPD. Although he is on oxygen therapy at 3L per nasal cannula his O2 saturation, measured using a pulse oximeter, has been around 89%

Question

He still becomes short of breath when talking or eating. Because of this, the nurse recommends a high-fat, high-protein diet because: 1. This will allow him to gain weight and develop muscle to help with recovery.
2. Both foods have "more calories per bite" allowing him to eat less but still get enough calories.
3. He is elderly and does not have to be worried about his risk for developing heart disease.
4. Foods high in protein and fats are easier to digest and less likely to cause indigestion.

Answer 1

2
Rationale: Frail clients with COPD should be encouraged to eat a diet that is high in calories to avoid fatigue and excessive energy use during meals. In this case, a choice of high-protein and high-fat foods are appropriate to provide the client with "more calories per bite," and will allow him to consume more calories with less chance of shortness of breath. Although it is true that weight gain may help to speed his recovery and he does not have to worry about developing CAD, the immediate concern is to provide the nutrients he needs while minimizing the energy needed. Foods containing high amounts of protein and fat take longer to digest.