For a female patient with chronic obstructive pulmonary disease, which nursing intervention would help maintain a patent airway?
A. Restricting fluid intake to 1,000 ml per day.
B. Enforcing absolute bed rest.
C. Teaching the patient how to perform controlled coughing.
D. Administering prescribed sedatives regularly and in large amounts.
Correct Answer: C. Teaching the patient how to perform controlled coughing.
Controlled coughing helps maintain a patent airway by helping to mobilize and remove secretions. Cough can be persistent but ineffective, especially if the patient is elderly, acutely ill, or debilitated. Coughing is most effective in an upright or in a head-down position after chest percussion.
Option A: A moderate fluid intake (usually 2 L or more daily) and moderate activity help liquefy and mobilize secretions. Hydration helps decrease the viscosity of secretions, facilitating expectoration. Using warm liquids may decrease bronchospasm. Fluids during meals can increase gastric distension and pressure on the diaphragm.
Option B: Bed rest may limit the patient’s ability to maintain a patent airway, causing a high risk for infection from pooled secretions. Assist the patient to turn every 2 hours. If ambulatory, allow the patient to ambulate as tolerated. Movement aids in mobilizing secretions to facilitate clearing of airways.
Option D: Administer bronchodilators if prescribed. More aggressive measures to maintain airway patency. Suction secretions as needed. Suctioning clear secretions that obstruct the airway, therefore, improves oxygenation.
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