A client presents to the clinic with complaints of otalgia and muffled sounds. The client is diagnosed with external otitis. Which of the following will the nurse not include in client teaching?

Choice A Reason: This is incorrect because rotating nursing staff may not provide emotional support for the client who is rehabilitating from major burns. The client may benefit from having consistent and familiar staff who can establish rapport and trust with him. The nurse should assign staff who are experienced and comfortable with burn care and who can communicate effectively and empathetically with the client.

Choice B Reason: This is incorrect because keeping family members aware of his condition may not provide emotional support for the client who is rehabilitating from major burns. The client may have privacy or confidentiality concerns or may not want his family members to see him in his current state. The nurse should respect the client's wishes and preferences regarding family involvement and obtain his consent before sharing any information.

Choice C Reason: This is correct because talking with the client during wound care can provide emotional support for the client who is rehabilitating from major burns. Wound care can be painful and stressful for the client, so the nurse should use therapeutic communication skills to distract, reassure, and encourage him. The nurse should also explain the procedures and rationale for wound care and allow the client to express his feelings and concerns.

Choice D Reason: This is incorrect because assigning assistive personnel to keep his room neat and clean may not provide emotional support for the client who is rehabilitating from major burns. The client may appreciate a clean environment, but he may also need more direct and personal contact with the nurse. The nurse should spend time with the client and provide holistic care that addresses his physical, psychological, social, and spiritual needs.

Choice A Reason: This is incorrect because encouraging coughing and deep breathing can increase intracranial pressure (ICP), which is the pressure inside

the skull that can affect brain function. Coughing and deep breathing can increase blood flow and oxygen demand to the brain, which can worsen cerebral edema. The nurse should suction the patient as needed and maintain a patent airway.

Choice B Reason: This is incorrect because positioning the patient with knees and hips flexed can increase ICP by reducing venous drainage from the head. The nurse should position the patient with neck and body in alignment and avoid extreme flexion or extension of any joints.

Choice C Reason: This is incorrect because performing nursing interventions once an hour can disturb the patient's sleep and increase ICP by stimulating brain activity. The nurse should cluster nursing interventions and provide quiet and dark environment to promote rest and reduce stress.

Choice D Reason: This is correct because keeping the head of the bed elevated to 30 degrees can decrease ICP by facilitating venous drainage from the head and reducing cerebral blood volume. The nurse should monitor the patient's blood pressure and pulse to ensure adequate cerebral perfusion.