A nurse at an outpatient mental health facility is monitoring effective use of stress management techniques for a client who is attending stress management group therapy. Which of the following statements made by the client indicates effective use of cognitive reframing?

Rationale:

A. Encourage the client to increase fluid intake: Clients receiving continuous peritoneal dialysis may need to restrict fluids to prevent volume overload, depending on residual kidney function and dialysis efficiency. Encouraging increased intake without provider orders can be harmful.

B. Obtain the client's weight: Daily weight is a critical indicator of fluid balance and dialysis effectiveness. Monitoring weight helps determine if the dialysis is removing the appropriate amount of fluid and supports adjustments to the treatment plan.

C. Palpate the access site for a thrill: A thrill is a vibration felt over an arteriovenous fistula, which is used in hemodialysis, not peritoneal dialysis. Peritoneal dialysis uses a soft catheter in the abdomen and does not produce a thrill.

D. Auscultate the access site for a bruit: A bruit, a whooshing sound heard over a vascular access, is associated with AV fistulas used in hemodialysis. It is not relevant for peritoneal dialysis, which uses a catheter and does not involve high-pressure blood flow.

Rationale:

A. "Prednisone can cause blood glucose levels to increase”: Prednisone is a corticosteroid that can increase blood glucose by promoting gluconeogenesis and reducing cellular glucose uptake. Monitoring glucose levels is important, especially in clients receiving moderate to high doses.

B. "Albuterol treatments can cause blood glucose levels to decrease.": Albuterol is more likely to cause mild hyperglycemia due to its beta-agonist activity, which can stimulate glycogenolysis. It does not typically cause a drop in blood glucose levels.

C. "Having COPD causes blood glucose levels to fluctuate.": COPD alone does not directly cause blood glucose fluctuations. However, glucose changes are more commonly influenced by treatments like corticosteroids rather than the disease itself.

D. "Older adults are at risk for developing type 1 diabetes mellitus.”: Type 1 diabetes is typically diagnosed in children and young adults due to autoimmune beta-cell destruction. Older adults are more at risk for type 2 diabetes, not type 1.