A client states, "At night, I usually need to sleep propped up on two pillows in the chair, but now it seems I need three pillows." What is the nurse's best response?
a. "You should try to rest more during the day."
b. "You should try to lie flat for short pe-riods of time."
c. "You need to stay in the hospital for fur-ther evaluation."
d. "You can take medication at night so you can sleep."
C
Orthopnea is the sensation of dyspnea or breathlessness in the supine position. Clients feel that they cannot catch their breath in the supine position and must rest or sleep in a semi-sitting posi-tion by placing pillows behind their backs or by using a reclining chair. The degree of breath-lessness can be measured roughly by the number of pillows needed to make the client less dysp-neic (e.g., one-pillow orthopnea, two-pillow orthopnea). With a client who has chronic respiratory problems, a minor increase in dyspnea may indicate a severe respiratory problem. Respiratory failure is a high risk. This client needs to stay in the hospital to be evaluated more completely. The client should not be instructed to try to lie flat, or to take a sleeping pill.
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