An older adult client is admitted with a severe exacerbation of chronic obstructive pulmonary disease (COPD). During evening rounds, the client reports extreme fatigue but states, "I cannot fall asleep because I feel like I am suffocating when I lie down." Which nursing action is most appropriate to promote comfort and facilitate rest for this client?
- ADelegate the continuous evaluation of the client's respiratory effort to the unlicensed assistive personnel.
- BAssist the client into a flat, supine position to maintain spinal and airway alignment.
- Position the client leaning forward over an overbed table supported by pillows.Answer
- DAttribute the client's nighttime restlessness to normal aging and limit routine room disruptions.
Answer
Position the client leaning forward over an overbed table supported by pillows.
Clients with chronic obstructive pulmonary disease (COPD) often experience orthopnea, which is severe dyspnea when lying flat. The most effective non-pharmacologic basic care measure to promote comfort and rest is assisting the client into the orthopneic position. By sitting up and leaning forward over an overbed table padded with pillows, the client's diaphragm drops, allowing for maximal chest expansion and decreasing the overall work of breathing.
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Key Concept
Basic Care and Comfort: Positioning to Promote Oxygenation and Rest