The nurse is conducting a health education group for retired clients with chronic obstructive pulmonary disease (COPD) to help them improve their respiratory effort and gas exchange.  The nurse should place the most emphasis on which of the following?

Do not shovel snow.


•Exposure to extreme temperatures and vigorous activities will further tax the respiratory system. It is better to avoid them in order to prevent respiratory distress or failure.

•Pacing activities and intermittent rest prevents fatigue, which will reduce respiratory effort.  Trying to do too much at one time may exacerbate COPD symptoms.

•Frequent, small meals help prevent a bloated stomach, which causes pressure on the diaphragm that makes it more difficult to breathe.

Elevating the head of the bed and frequent repositioning allows for better lung expansion and air movement. It will be more difficult for patients with COPD to breathe when supine.

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