A nurse-initiated or independent activity for promotion of respiratory function in a terminally ill patient is to:
a. limit PO fluid intake.
b. position the patient in semi-Fowler's or Fowler's position.
c. reduce narcotic analgesic use.
d. administer bronchodilators.
B
Position the patient in semi-Fowler's or Fowler's position. This promotes maximal ventilation, lung expansion, and drainage of secretions. Limiting fluids may not promote respiratory function, and unless a patient is on a fluid-restricted diet, the nurse should not do so. Reducing narcotic analgesic use is not a nurse-initiated activity to promote respiratory function. Respiratory rate should be assessed before narcotics are administered, to prevent further respiratory depression. Management of air hunger involves judicious administration of morphine and anxiolytics for relief of respiratory distress. The administration of bronchodilators would require a physician's order. It is not an independent nursing activity.
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