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Unfolding Case Study

1.
b. The pulmonary or respiratory system comprises the upper airways, the lower airways, lungs, and alveolar sacs. The primary function of the pulmonary system is to ensure adequate oxygenation throughout the body.
2.
c. Aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) can induce bronchospasm in clients who are sensitive and have had reactions to these medications in the past.
3.
b. Processed meats and aged cheeses are high in histamines and can cause increased mucus production, which can worsen asthma symptoms.
4.
a. Protein drinks provide high protein amounts in low-volume portions to provide the nutritional components necessary for muscle synthesis and improved muscle strength.
5.
a. Eating protein, found in foods like cheese and nuts, at least twice daily will help with strong respiratory muscles.
6.
c. Obesity alters the mechanics of the pulmonary system leading to dyspnea, wheezing, airway hyperresponsiveness, and increased work of breathing.

Review Questions

1.
c. Fatigue is a common symptom of COPD that can make it difficult for the client to prepare and eat nutritious foods.
2.
c. Albumin is the primary protein of the body. Decreased levels may indicate chronic disease, malabsorption, malnutrition with low protein, or dilution by IV fluids. Follow-on diagnostics would be pre-albumin and blood urea nitrogen.
3.
b. The process of gas exchange is when oxygen and carbon dioxide are exchanged in the alveoli of the lungs.
4.
a. Calcium and vitamin D intake reduce the risk of osteoporosis and kyphoscoliosis that decrease the size and diameter of the rib cage and reduce lung capacity.
5.
c. The client should eat high-protein, calorie-dense meals to maintain nutritional status and prevent weight loss that results from increased work of breathing.
6.
a. A primary goal of nutrition therapy for pulmonary wellness is to maintain adequate respiratory function to decrease or prevent malnutrition and obesity. Healthy body weight will help preserve muscle strength and help maintain the integrity of the immune system.
7.
d. The client should eat smaller, more frequent meals. Larger meals should be consumed earlier in the day when the client is less tired.
8.
c. Crackles indicate crepitus, or air trapped in and under the skin.
9.
d. While all of these findings can indicate the client is knowledgeable of and is following the prescribed nutritional plan, actually maintaining the recommended weight is an objective measure that indicates adherence.
10.
d. ACE inhibitors are known to induce nighttime coughing.
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