The nurse is starting preoperative teaching when the client ...

[dakota nelson]

The nurse is starting preoperative teaching when the client receives a phone call. When the nurse resumes teaching, the client is visibly upset and begins to cry.
 
  Which therapeutic initial response by the nurse is appropriate?
  A) Whatever is upsetting you can be dealt with once we have finished.
  B) It is very important to focus on this teaching so that you will recover quickly after surgery.
  C) I can see the phone call has upset you. Let's talk about why you are upset before we move on with teaching.
  D) What can you do to solve the problem?

Question 2

A nurse is on the elevator preparing to start a 12-hour shift after visiting a sick family member when two other nurses enter.
 
  The nurses start talking negatively about a client they are caring for on a medical-surgical unit in the hospital. Although there are no clients on the elevator, which action by the first nurse in the elevator is appropriate?
  A) Ask the nurses to stop talking in public.
  B) Report the nurses to the unit manager.
  C) Speak to the nurses in a private place.
  D) Report the nurses to the risk manager.

[Juro]

Answer to Question 1

Answer: C

When clients are anxious and upset, they have difficulty focusing, especially on new information, and their anxiety becomes a barrier to effective communication. The nurse needs to prioritize the client's presenting need to express concerns and then engage in teaching at a later time, when the client is able to comprehend. Telling the client to focus will not relieve the anxiety of the imminent issue. Because the nurse is unaware of the issue and is not knowledgeable of the client's situation, it is false reassurance to tell the client that the matter can be handled after the teaching is completed. This also belittles the client's independence and self-efficacy, as does recommending problem solving.

Answer to Question 2

Answer: C

Nursing integrity ensures that patients' rights are respected in the healthcare setting. If the nurse were to confront the two colleagues on the elevator, it could be overheard by others. The nurse should wait to speak to the other nurses privately about the breach of confidentiality. The nurse could report the incident to the unit manager, but it would be best for the nurse to confront the two colleagues in a professional way. The nurse should confront the two colleagues in a private manner in a professional way. If that cannot be done, then notifying the nurse manager would be the next step. The risk manager is only involved in situations where there is an injury to the staff or a client.

[dakota nelson]

Thank you

[Juro]

Happy to help you