A client who has type 1 diabetes mellitus asks a nurse about beginning an exercise regimen.

Which of the following instructions should the nurse include?

Correct answer: D

A) Encouraging the client to discuss the decision with her family can provide emotional support and help in decision-making.

B.Given that the client has already decided to stop dialysis treatment, discussing alternative treatment methods may not align with the client's wishes. It's essential for the nurse to respect the client's decision and provide support rather than trying to persuade the client to reconsider their decision.

C) Asking the facility chaplain to visit the client can offer emotional and spiritual support, addressing the client's needs in that aspect.

D. Supporting the client's decision to stop dialysis treatment is essential for respecting the client's autonomy and dignity. The nurse should provide emotional support, educate the client about what to expect, and ensure that appropriate palliative care measures are in place to keep the client comfortable and provide symptom management.

Stressors can be categorized as external or internal. External stressors are factors or events in the environment that can cause stress.
In this case, the recent move to a new city is an external stressor because it is an event that has occurred outside of the client and is influencing their current state of stress. Moving to a new city can bring about significant changes and challenges, such as adjusting to a new environment, finding new social connections, and adapting to unfamiliar surroundings.
B. Feeling depressed is an internal stressor because it relates to the client's emotional state or mental health condition. Depression can be caused by various factors, such as biochemical imbalances, life circumstances, or genetic predispositions.

C. Lack of nutritional knowledge: This is an internal stressor because it refers to the client's lack of knowledge or awareness regarding nutrition. While the lack of nutritional knowledge can contribute to stress, it is an internal factor that can be addressed through education and learning.
D. While recurring urinary tract infections can be stressful for the client, they are considered an internal stressor because they involve a physical condition or health issue within the client's body. Addressing and managing the infections would involve medical interventions and possibly lifestyle modifications.