After an acute exacerbation of chronic obstructive pulmonary disease (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 hospitalizations for exacerbation 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 food.
C
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A Incorrect. The nurse teaches the patient this technique to ease breathing for tran-sient dyspnea that occurs after exertion or while eating. This technique, however, is unlikely to prevent a hospitalization for a patient with an exacerbation of COPD.
B Incorrect. The patient with COPD uses oxygen regularly or for dyspnea as pre-scribed. Oxygen provides symptomatic relief of dyspnea and does not prevent hospitalizations for exacerbated COPD.
C Correct. The nurse helps the patient with COPD to 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. This helps to avoid hospitalizations for COPD because a pulmonary infection can have a devastating impact on a patient who has com-promised 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.
D Incorrect. Eating nutrient- and calorie-dense food is important in COPD because the patients work very hard at breathing, so the patients need the calories and nutrition to supply fuel for the work of breathing. In addition, patients with COPD should eat these foods because it is difficult for them to eat in sufficient quantities for their needs; so the food they do eat must contain many calories and nutrients. This is not the most important aspect of preventative therapy for patients with COPD, however, because an infection is more likely to cause a more devastating problem faster than nutritional issues.
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