Which statement by a client with chronic obstructive pulmonary disease (COPD) indicates a need for further instruction about positions to ease breathing during dyspneic episodes?

The statement expressing a preference to lie flat on one's side in a fetal position indicates a need for further instruction because this position can potentially restrict diaphragmatic movement and hinder effective lung expansion. For individuals with chronic obstructive pulmonary disease (COPD), the goal during episodes of dyspnea is to promote optimal lung function and facilitate breathing.

Positions that allow for expansion of the chest cavity and improve ventilation are recommended. Sitting up and leaning forward on a table, reclining with feet elevated, or standing while bending slightly forward are all positions that promote better airflow and reduce the sensation of breathlessness. These positions help to engage accessory muscles of respiration and improve the efficiency of breathing, making them more suitable for individuals experiencing dyspnea related to COPD.

In contrast, lying flat, especially in a constricted position like the fetal position, can lead to increased work of breathing and discomfort, making it counterproductive for someone with a chronic respiratory condition. The correct understanding of positioning is crucial for managing symptoms efficiently and enhancing the quality of life in individuals with COPD.