QuestionJuly 2, 2025

A client with chronic obstructive pulmonary disease (COPD) is using pursed-lip breathing while he is sitting up in a chair by the bedside. The practical nurse (PN) obtains his respiratory rate at 20breaths/minute and his pulse oximetry is 91% on room air. What action should the PN implement? Encourage the client to sit up and lean forward. Give oxygen 15liters/minute per non-rebreather mask. Reinforce the use of an incentive spirometer. Obtain a prescription for arterial blood gases (ABGs)

A client with chronic obstructive pulmonary disease (COPD) is using pursed-lip breathing while he is sitting up in a chair by the bedside. The practical nurse (PN) obtains his respiratory rate at 20breaths/minute and his pulse oximetry is 91% on room air. What action should the PN implement? Encourage the client to sit up and lean forward. Give oxygen 15liters/minute per non-rebreather mask. Reinforce the use of an incentive spirometer. Obtain a prescription for arterial blood gases (ABGs)
A client with chronic obstructive pulmonary disease (COPD)
is using pursed-lip breathing while he is sitting up in a chair
by the bedside. The practical nurse
(PN) obtains his
respiratory rate at
20breaths/minute
and his pulse oximetry
is 91% 
on room air. What action should the PN implement?
Encourage the client to sit up and lean forward.
Give oxygen 15liters/minute per non-rebreather mask.
Reinforce the use of an incentive spirometer.
Obtain a prescription for arterial blood gases (ABGs)

Solution
4.7(201 votes)

Answer

Encourage the client to sit up and lean forward. Explanation 1. Assess the current situation The client is using pursed-lip breathing, a technique to help improve ventilation and oxygenation in COPD patients. His respiratory rate is 20 breaths/minute, which is within normal limits, and his pulse oximetry is ( ( \(91\%\) ) ), slightly below the typical target range for COPD patients (usually ( ( \(88-92\%\) ) )). 2. Determine appropriate intervention Given the client's stable respiratory rate and the use of pursed-lip breathing, immediate high-flow oxygen is not necessary. An incentive spirometer is more useful for post-operative patients to prevent atelectasis, not primarily for COPD management. Obtaining ABGs would provide detailed information about gas exchange but is not immediately necessary unless there are signs of acute distress or significant changes. 3. Implement supportive positioning Encouraging the client to sit up and lean forward can enhance lung expansion and facilitate easier breathing, which aligns with the current use of pursed-lip breathing.

Explanation

1. Assess the current situation<br /> The client is using pursed-lip breathing, a technique to help improve ventilation and oxygenation in COPD patients. His respiratory rate is 20 breaths/minute, which is within normal limits, and his pulse oximetry is ( \(91\%\) ), slightly below the typical target range for COPD patients (usually ( \(88-92\%\) )).<br /><br />2. Determine appropriate intervention<br /> Given the client's stable respiratory rate and the use of pursed-lip breathing, immediate high-flow oxygen is not necessary. An incentive spirometer is more useful for post-operative patients to prevent atelectasis, not primarily for COPD management. Obtaining ABGs would provide detailed information about gas exchange but is not immediately necessary unless there are signs of acute distress or significant changes.<br /><br />3. Implement supportive positioning<br /> Encouraging the client to sit up and lean forward can enhance lung expansion and facilitate easier breathing, which aligns with the current use of pursed-lip breathing.
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