23) ANSWER

C) Follow prescribed weight loss plan.

Explanation

A client diagnosed with Pickwickian syndrome is typically clinically obese and has hypoventilation symptoms. A realistic goal is to establish a weight loss plan because it will help to improve breathing, relieve respiratory symptoms, and decrease the workload placed on both the heart and lungs. Option 1 is incorrect because maintaining the client's current weight will not help to improve clinical symptoms. Option 2 is incorrect as increasing caloric intake will further contribute to weight gain and affect respiratory status. Although the use of increased fluids may be helpful to thin secretions, the client with Pickwickian syndrome does not present with thick secretions, but rather has disturbances with sleep apnea. Critical words are Pickwickian syndrome and most realistic. Recall aspects of this syndrome to be directed to option 3.