5.2.5: FRAME 5- Take Action
- Page ID
- 90249
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CORRECT Answer
Question Type: Matrix Multiple Choice
Scoring: 0/1
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
After reviewing the client’s chart, what interventions would you recommend to Stanley for self-management of his COPD?
| Intervention | Recommend | Not Recommend |
|---|---|---|
| Administer a dose of amitriptyline for anxiety | X | |
| Encourage eating small, frequent meals | X | |
| Educate on how to take medications correctly | X | |
| Instruct how to use oxygen appropriately | X | |
| Take sleeping medications for rest and sleep | X | |
| Sleep in recliner chair to aid with restful nights | X | |
| Obtain weekly weight and assess trends | X | |
| Reduce exposure to pollens | X | |
| Continue efforts for smoking cessation | X |
RATIONALE
The nurse recognized that it is difficult for Stanley to eat and that he does not feel hungry. Eating small frequent meals may be more tolerable for Stanley. Nutritional supplements may also help with caloric intake. Monitoring Stanley’s weight and observing trends will allow for earlier intervention of cachexia. It is important to review the client’s medications/treatments and assess proper use and compliance. Having the client demonstrate how he prepares and administers his nebulizer and inhalers and determines how much oxygen is in the oxygen tanks is an effective way to assess his knowledge and compliance.
Sleeping in a recliner optimizes client positioning to avoid pressure exerted by gravity when lying flat in a bed. An upright position helps to elevate the torso, expand the rib cage, and control coughing. It is important for the nurse to assess triggers for COPD exacerbations. Common triggers include common allergens and pollens. Allergens and pollens can irritate the lungs and create more breathing problems. The nurse should also encourage smoking cessation support and referral.
FOCUSED GUIDE
Chronic disease affects health and quality of life. It also is a significant driver of healthcare costs and has a related impact on business, such as absenteeism and presenteeism. Nearly 60% of adult Americans have at least one chronic disease. More than two-thirds of all deaths are caused by one or more of five chronic diseases: heart disease, cancer, stroke, chronic obstructive pulmonary disease, and diabetes (Hoffman, 2022).
Further, approximately 40% of American adults have multiple chronic conditions and evidence is growing that one chronic illness has a negative impact on the risk of developing others, particularly as people age. The nation’s aging population coupled with existing risk factors (e.g., tobacco use, poor nutrition, and lack of physical activity) suggest that that these problems will continue to grow if they are not effectively addressed (Hoffman, 2022).
Additional risk reduction interventions for Stanley include but are not limited to:
- Using a cane when walking on the sidewalk.
- Not smoking with oxygen therapy.
- Re-orienting to place and time to enhance safety.
- Wear clothing that first appropriately to avoid tripping.
- Obtain a Medical alert system. o Wear supportive, non-slip walking shoes.
- Assess home for mold or other allergens.
- Check window to be sure they close correctly to lessen exposure to seasonal pollens.
- Is the temperature of his apartment appropriate? Does he have functioning air conditioning/heat?
- Does he have mouth sores and/or proper fitting dentures?