After an acute exacerbation of COPD, the nurse prepares an older adult for discharge to home. Which is the most important patient teaching for the nurse to include for the prevention of hos-pitalizations for exacerbations of COPD?
a. Ease breathing by sitting upright.
b. Use low-flow oxygen for dyspnea.
c. Avoid sick people and wash hands.
d. Eat nutrient- and calorie-dense foods.
C
The nurse helps the patient with COPD maintain health and wellness by preventing infection. To accomplish this, the nurse instructs the patient to avoid people with contagious illnesses to reduce exposure to communicable diseases and to wash hands frequently to reduce exposure to microorganisms as potential pathogens. Following these instructions will help the patient avoid hospitalizations for COPD; a pulmonary infection can have a devastating impact on a patient who has compromised pulmonary reserves. Fluid and exudates accumulate in the lungs to de-crease oxygenation and ventilation, and the patient with COPD is less able to cough and expel sputum.
The nurse teaches the patient to sit upright to ease breathing for transient dyspnea that oc-curs after exertion or while eating. This technique, however, is unlikely to prevent a hospitaliza-tion for the patient with an exacerbation of COPD. The patient with COPD regularly uses oxygen for dyspnea as prescribed. Oxygen provides symptomatic relief of dyspnea but does not prevent hospitalizations for exacerbated COPD. Eating nutrient- and calorie-dense food is also important. Patients with COPD work very hard at breathing; therefore the patient needs the calories and nutrition to supply fuel for the work of breathing. In addition, patients with COPD should eat these foods because eating them in sufficient quantities to meet their needs is often difficult; therefore the food they do eat must contain many calories and nutrients. Nutritional issues are not the most important aspect of preventative therapy for patients with COPD; an infection is more likely to cause a more devastating problem.
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