A client receives new prescriptions at 1000 that include discontinuing IV fluids and IV antibiotics. Which prescription should the practical nurse (PN) administer at 1300?

When admitting a client with complications of left-sided heart failure, the practical nurse (PN) should prioritize assessing the client's bilateral lung sounds. Left-sided heart failure can result in the accumulation of fluid in the lungs, leading to pulmonary congestion and impaired gas exchange. By auscultating the client's lung sounds, the PN can assess for the presence of crackles, wheezes, or diminished breath sounds, which are indicative of pulmonary congestion and fluid accumulation. This assessment helps to identify the severity of the client's condition and guides further interventions and treatment.

While assessing heart sounds (option a) is important in evaluating cardiac function, assessing lung sounds takes priority as pulmonary congestion is a common manifestation of left-sided heart failure. Chest pain (option b) is a significant symptom that should be assessed promptly, but in this scenario, the focus is on assessing for signs of pulmonary congestion and impaired gas exchange. Assessing the client's mood and affect (option d) is important for a comprehensive assessment, but it is not the priority when the client is admitted with complications of left-sided heart failure.

This comment by the practical nurse (PN) is likely to be the most helpful to the client. By offering to sit with the client, the PN shows empathy, support, and a willingness to provide companionship. This approach acknowledges the client's feelings of isolation and offers a listening ear. It provides an opportunity for the client to express his emotions, thoughts, or concerns if he wishes to do so. The presence of a caring and compassionate individual can help alleviate some of the client's feelings of loneliness and may encourage him to open up and engage in conversation or activities when he is ready.

A. "Come into the recreation area. We have your favorite card game and I will play it with you."
This choice assumes that engaging in a specific activity will automatically help the client and solve his current feelings of reclusiveness. While offering an activity may be beneficial in some cases, it is important to first address the client's emotional state and provide support before suggesting specific activities. Pushing the client to participate in an activity without acknowledging his current feelings may further alienate him and not address the underlying issues causing his reclusive behavior.
B. "Why do you want to stay in your room today?"
This choice may come across as confrontational or judgmental. Asking why the client wants to stay in his room implies that there is something wrong with his decision or that he needs to justify his behavior. This approach may make the client defensive or withdraw further. It is essential to create a safe and supportive environment where the client feels understood and validated, rather than questioning his choices.
C. "I know you are sad about not seeing your family as often, but they are visiting as much as they can."
While acknowledging the client's sadness about not seeing his family is important, dismissing his feelings by stating that his family is visiting as much as they can minimize or invalidate his emotions. It is crucial to provide empathy and validate the client's emotions without making assumptions or downplaying his experiences. This approach may not address the client's current state of reclusiveness or provide the support he needs.