b.Place the patient in the Trendelenburg posi-
tion to drain the right lobe of the lung.
c.Carry out postural drainage two to four
times a day for 20 to 30 minutes.
d.Perform postural drainage 15 minutes after
meals to aid digestion.
e.Place the patient in a lying position, half
on the abdomen and half on the side, right
and left, to drain the posterior sections of
the upper lobes of the lungs.
f.Place the patient lying on the right side
with a pillow under the chest wall to drain
the right lobe of the lung.
8.Which of the following statements describes
the proper use of inhaled medications? (Select
all that apply.)
a.Bronchodilators are used to liquefy or
loosen thick secretions or reduce inflamma-
tion in airways.
b.Nebulizers are used to deliver a controlled
dose of medication with each compression
of the canister.
c.When using an MDI, the patient must acti-
vate the device before and after inhaling.
d.DPIs are actuated by the patient’s inspiration,
so there is no need to coordinate the delivery
of puffs with inhalation.
e.Metered-dose inhalers deliver a controlled
dose of medications with each compression
of the canister.
f.Inhalers can be used safely without serious
side effects whenever they are needed by
the patient.
9.Which of the following nutritional guidelines
are recommended for a patient with COPD?
(Select all that apply.)
a.The patient should follow a high-protein
and low-calorie diet.
b.The diet should consist of 40% to 55% car-
bohydrates.
c.The diet should be rich in antioxidants and
vitamin A, C, and B.
d.The diet should contain 45% to 50% fat to
counter malnutrition.
e.The diet should contain 12% to 20%
protein.
f.Obese patients should not be encouraged to
try to lose weight to prevent malnutrition
from occurring as the disease progresses.Prioritization Questions
1.Place the following steps for teaching a patient
to use an incentive spirometer in the order in
which they should occur.
a.Instruct the patient to exhale normally and
then place lips securely around mouthpiece
and not to breathe through his or her nose.
b.Medicate with ordered pain medication if
needed.
c.Tell patient to hold breath and count to
three. Check position of gauge to determine
progress and level attained.
d.Tell patient to complete breathing exercises
about 10 times every hour, if possible, and
to rest between breaths as necessary.
e.Assist patient to upright position if possible
and remove dentures if they fit poorly.
f.Demonstrate how to steady device with
one hand and hold mouthpiece with other
hand.
g.Instruct the patient to inhale slowly and as
deeply as possible through the mouthpiece.
h.Instruct the patient to remove lips from
mouthpiece and exhale normally.CHAPTER 39 OXYGENATION 265
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:2.Place the following steps for inserting a
nasopharyngeal airway in the order in which
they should occur.
a.Remove the airway and place it in the other
naris at least every 24 hours; assess for skin
breakdown.
b.Perform hand hygiene and don gloves
(wear mask and goggles if patient is
coughing).
c.Explain the procedure to the patient.
d.Gently insert the airway into the naris. If
resistance is met, stop and try inserting it
into the other naris.
e.Lubricate the airway with the water-soluble
lubricant; position the patient on his/her
back or in a side-lying position.
f.Use an airway that is the correct size (size
28 French is an average adult size).LWBK696-C39_p262-271.qxd 9/3/10 12:35 PM Page 265 Aptara Inc