Question

The physician has ordered chest physiotherapy for a client with chronic obstructive lung disease. When performing chest physiotherapy the nurse should give priority to: A. Covering the client's chest with a towel B. Placing the client in a prone position C. Beginning percussion in the lower lobes D. Making sure that the client's face is visible

Short answer

Answer: D. Making sure that the client's face is visible.

Step-by-step solution

Understanding chest physiotherapy

Chest physiotherapy is a technique used to help clients with respiratory issues, such as chronic obstructive lung disease. It involves manual techniques like percussion and vibrations to help loosen and drain mucus from the airways. The goal is to improve breathing and overall lung function.

Analyzing the options

Now we will look into each of the given options and discuss how they relate to chest physiotherapy. A. Covering the client's chest with a towel - While this might be a practice to protect the client's skin, it is not the top priority in this situation. B. Placing the client in a prone position - Positioning a client is important for effective drainage, but it is not the primary focus in this scenario. C. Beginning percussion in the lower lobes - Percussion is a key part of chest physiotherapy, but the focus on the lower lobes is not the highest priority. D. Making sure that the client's face is visible - Monitoring the client's comfort and response is important during the procedure, and having their face visible allows the nurse to recognize any signs of distress.

Determining the priority action

After analyzing each option, it becomes clear that the top priority in this situation is: D. Making sure that the client's face is visible. This is because it allows the nurse to properly monitor the client's comfort, response, and potential signs of distress during the chest physiotherapy procedure, making it the most important aspect to prioritize.

Key concepts

Chronic Obstructive Lung Disease

Chronic obstructive lung disease (COPD) is a progressive inflammatory lung disease that obstructs airflow, making it difficult for patients to breathe. It typically includes conditions like emphysema and chronic bronchitis.

COPD leads to the accumulation of mucus in the airways, causing obstructions and poor air exchange. This reduced lung capacity means that patients with COPD are at an increased risk of pneumonia, chronic respiratory failure, and other complications which require meticulous respiratory care, often including chest physiotherapy.

Understanding COPD Management

• Smoking Cessation: The first and most crucial step in managing COPD is smoking cessation to slow the progression of the disease.
• Medications: Bronchodilators, corticosteroids and combination inhalers play significant roles in managing symptoms.
• Oxygen Therapy: Some patients may require supplemental oxygen to maintain adequate blood oxygen levels.
• Pulmonary Rehabilitation: This includes exercise, education, and support to improve the quality of life.

Successful management of COPD also includes vaccinations, healthcare maintenance, and recognizing acute exacerbations promptly for early intervention.

Respiratory Care in Nursing

Respiratory care in nursing is vital for patients with pulmonary conditions, especially those with COPD. Nurses play a central role in the management and monitoring of such patients.

Key Aspects of Respiratory Care

• Assessment: Regular assessment of respiratory status, including rate, depth, rhythm, and the presence of cough or sputum.
• Oxygen Administration: Appropriate administration of oxygen therapy based on the patient's oxygenation status.
• Airway Management: Maintenance of a patent airway and providing care such as suctioning if necessary.
• Chest Physiotherapy: Techniques like percussion and postural drainage to help patients clear their airways from mucus.
• Monitoring: Close monitoring for signs of respiratory distress and intervention when necessary.

In the context of chest physiotherapy mentioned in the exercise, monitoring the patient's response is crucial. Ensuring the client's face is visible allows for immediate recognition of distress or discomfort, reflecting the dynamic nature of respiratory care in nursing practice.

NCLEX-RN Exam Preparation

Preparing for the NCLEX-RN (National Council Licensure Examination-Registered Nurse) is a critical step for nursing students to become licensed practitioners. This comprehensive exam covers a wide array of topics, including the proper techniques and priorities for respiratory care.

Study Tips for NCLEX-RN Candidates

• Understand the Test Structure: The exam uses a computer adaptive testing format, so familiarizing yourself with the structure is important for time management and reducing anxiety.
• Review Core Content: Focus on core nursing content areas such as pharmacology, medical-surgical nursing, pediatrics, and respiratory care, as in the example regarding chest physiotherapy.
• Practice Questions: Regularly completing practice questions helps to identify knowledge gaps and become accustomed to the style of questions asked on the exam.
• Simulation Exams: Taking full-length simulation exams can build endurance and timing skills essential for the actual test day.

When studying for the NCLEX-RN, understanding the rationale behind care priorities, as in choosing the importance of the patient's visible face during chest physiotherapy, is crucial. It mirrors real clinical decision-making and enhances a nurse's ability to provide safe and effective care upon licensure.