A nurse assisting with the care of a client who is admitted to the medical-surgical unit.

The nurse is reviewing the client's laboratory findings and vital signs.

Select the 5 findings that require immediate follow-up.

A) I’d like to hear your thoughts about giving yourself this medication:
This response encourages open communication and allows the client to express their concerns or fears. It shows empathy and provides an opportunity for the nurse to understand the reasons behind the refusal, which can help tailor the teaching approach. This is an effective way to build trust and involve the client in their care plan.

B) Have you considered how your decision to refuse medication will affect your family?
While this statement highlights the consequences of the client’s actions, it can feel judgmental or guilt-inducing, which may cause the client to become defensive. The nurse should aim to engage the client in a non-judgmental and supportive way rather than focusing on external consequences at this stage.

C) Why don’t you want to learn how to give yourself your medication?
This question could come across as confrontational and may make the client feel pressured or defensive. Instead of focusing directly on the refusal, the nurse should try to understand the client's perspective and barriers, which can be better achieved with a more open and empathetic approach like option A.

D) You will suffer serious health issues if you don’t take your medication:
This response may evoke fear and could be perceived as coercive. It focuses on the negative consequences without first understanding the client’s feelings or reasons for refusing. While the nurse should eventually address the importance of insulin, it’s more effective to first create an open dialogue that respects the client’s autonomy and concerns.

A) Open the fireplace dampers in the day room:
Opening the fireplace dampers in the event of an external chemical disaster would not be appropriate. In fact, this could allow toxic air or chemicals to enter the facility. It is important to seal off ventilation points that might allow the chemicals to enter, such as windows, doors, and any other openings, rather than opening the dampers.

B) Move clients to a room above ground with few windows:
In the event of an external chemical disaster, moving clients to a room above ground with few windows is a key safety measure. Rooms that are above ground level tend to be safer in such situations because chemicals may settle at ground level, increasing exposure risks to those below ground. A room with few windows is also important because it minimizes potential entry points for toxic substances from outside. The focus is on containing the air supply and limiting exposure to harmful agents.

C) Turn on fans in the facility to circulate air:
Turning on fans in the facility during a chemical disaster could worsen the situation by spreading toxic air or chemicals throughout the building. Fans are generally used to circulate air, but in this context, they would not be helpful and could potentially increase exposure to harmful substances. Instead, the focus should be on reducing airflow from the outside and sealing off the building.

D) Cover the electrical outlets with wet towels:
Covering electrical outlets with wet towels is not an effective response to an external chemical disaster. While wet towels can be useful in some scenarios for filtering or protecting from certain substances, in a chemical disaster, the priority is to ensure proper ventilation control and to protect from airborne chemicals by sealing the room. Electrical outlets should be covered for safety only when there is a risk of electrical hazards, but not necessarily in the case of a chemical disaster unless there is specific concern about sparks or fire.