Nurse Eve formulates a nursing diagnosis of Activity intolerance related to inadequate oxygenation and dyspnea for a client with chronic bronchitis.
To minimize this problem, the nurse instructs the client to avoid conditions that increase oxygen demands. Such conditions include:
- a- drinking more than 1,500 ml of fluid daily.
- b- being overweight.
- c- eating a high-protein snack at bedtime.
- d- eating more than three large meals a day.
Answer B.
- Conditions that increase oxygen demands include obesity, smoking, exposure to temperature extremes, and stress.
- A client with chronic bronchitis should drink at least 2,000 ml of fluid daily to thin mucus secretions; restricting fluid intake may be harmful.
- The nurse should encourage the client to eat a high-protein snack at bedtime because protein digestion produces an amino acid with sedating effects that may ease the insomnia associated with chronic bronchitis.
- Eating more than three large meals a day may cause fullness, making breathing uncomfortable and difficult; however, it doesn’t increase oxygen demands.
- To help maintain adequate nutritional intake, the client with chronic bronchitis should eat small, frequent meals (up to six a day).
The most likely condition to avoid to minimize oxygen demands for a client with chronic bronchitis is: b. being overweight.
Here's why the other options are less likely to be problematic:
a. Drinking more than 1,500 ml of fluid daily:
Adequate hydration is crucial for lung function, especially for someone with chronic bronchitis. Increased fluids can help thin secretions and make them easier to expel, improving breathing.
c. Eating a high-protein snack at bedtime:
Protein intake is essential for overall health and muscle maintenance, which can indirectly help with respiratory effort. A small high-protein snack is unlikely to significantly impact oxygen demands.
d. Eating more than three large meals a day:
While large meals can temporarily increase metabolic rate and oxygen demand, this is usually a transient effect. Eating smaller, more frequent meals might be more comfortable for someone with chronic bronchitis, but it wouldn't significantly reduce oxygen needs.
Disadvantages:
However, being overweight carries several disadvantages for people with chronic bronchitis:
- Increased work of breathing: Excess weight puts additional strain on the diaphragm and other respiratory muscles, making it harder to breathe, especially during exertion.
- Reduced lung capacity: Fat tissue can compress the lungs, further limiting lung function and oxygen intake.
- Decreased oxygen diffusion: Excess body fat can decrease the efficiency of oxygen transfer from the lungs to the bloodstream.
- Therefore, managing weight is an important strategy for improving oxygenation and reducing dyspnea in individuals with chronic bronchitis. Nurse Eve's advice to avoid being overweight is sound and aligns with evidence-based management practices for this condition.
Remember, this is just one aspect of managing chronic bronchitis. A comprehensive approach involving medication, lifestyle modifications (including weight management), and pulmonary rehabilitation is often necessary for optimal outcomes.
