A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions?

A) "I don't take naps throughout the day": This statement indicates a good sleep habit, as avoiding daytime naps can help promote better sleep at night.
B) "I have a small snack and take a bath before going to bed each day": This statement suggests a bedtime routine, which can be beneficial for promoting relaxation and signaling the body that it's time to sleep.
C) "I go to bed and get up routinely at the same time each day": Consistency in sleep schedule is an essential aspect of healthy sleep habits, as it helps regulate the body's internal clock and promotes better sleep quality.
D) "I watch television until I fall asleep at night": This statement indicates a poor sleep habit. Screen time before bedtime, especially from devices like televisions, computers, or smartphones, can interfere with the body's natural sleep-wake cycle and make it harder to fall asleep. The blue light emitted by screens can suppress the production of melatonin, a hormone that regulates sleep, leading to difficulty falling asleep and poor sleep quality. Therefore, this statement suggests a need for further teaching about avoiding screen time before bedtime to promote better sleep hygiene.

A. Turn the client on his side before starting oral care: This is the correct action. Turning the client on their side helps prevent aspiration of oral secretions or fluids during oral care, especially for an immobile client who may have difficulty swallowing or managing oral secretions effectively. Positioning the client on their side also facilitates better access to the oral cavity for oral care procedures.

B. Use the thumb and index finger to keep the client's mouth open: Using the thumb and index finger to keep the client's mouth open may cause discomfort or injury to the client. Instead, it's essential to encourage the client to open their mouth gently or use an appropriate oral device to keep the mouth open during oral care.

C. Apply petroleum jelly to the client's lips after oral care: Applying petroleum jelly to the client's lips after oral care can help keep the lips moisturized and prevent dryness. However, it is not the most immediate action necessary for oral care. Ensuring proper positioning and cleaning of the oral cavity take precedence during oral care for an immobile client.

D. Use a stiff toothbrush to clean the client's teeth: Using a stiff toothbrush can cause damage to the client's oral tissues, especially if the client has impaired oral hygiene or compromised oral health. It's essential to use a soft-bristled toothbrush or sponge swabs for oral care to prevent injury or trauma to the oral mucosa, especially in clients who are immobile.