A nurse in a clinic is teaching a client who has diabetes mellitus about self-administration of insulin using a prefilled, multidose pen. Which of the following instructions should the nurse include?

A. A nurse administers a medication without first identifying the client.

Negligence refers to the failure to provide care that a reasonable and prudent person would normally perform in a similar situation, resulting in harm to the client. In this scenario, administering medication without first identifying the client constitutes negligence because it violates the standard of care expected of a nurse. Proper identification of the client is essential to ensure that the correct medication is administered to the right individual, preventing medication errors and potential harm.

B. A nurse begins a blood transfusion without obtaining consent from a client:

This situation involves a failure to obtain informed consent, which is a violation of the client's rights but does not necessarily constitute negligence. Negligence typically involves a failure to provide proper care rather than a failure to obtain consent.

C. An assistive personnel prevents a client from leaving the facility:

While preventing a client from leaving the facility without appropriate authorization may be inappropriate or a breach of the client's rights, it does not necessarily constitute negligence. Negligence involves a failure to provide care that meets the standard of care expected in a given situation.

D. An assistive personnel discusses client care in the facility cafeteria with visitors present:

This situation may involve a breach of confidentiality or privacy but does not constitute negligence unless the discussion leads to harm or adverse consequences for the client. Negligence typically involves a failure to provide care that results in harm or injury to the client.

A. The client leans to the left side while sitting: While leaning to one side may indicate weakness or impaired balance, it is not as immediately concerning as the risk of aspiration. Addressing issues related to positioning and balance is important but may not pose an immediate threat to the client's safety.

B. The client coughs frequently while eating.

Coughing frequently while eating can indicate a risk of aspiration, which is a serious concern in stroke patients with left-sided weakness. Aspiration can lead to pneumonia and other respiratory complications. Therefore, it is crucial for the nurse to address this finding promptly to prevent potential respiratory compromise.

C. The client is consuming 25% of their meals: Poor oral intake and difficulty eating are concerning but do not pose an immediate threat to the client's safety compared to the risk of aspiration. However, addressing inadequate nutrition and hydration is essential for the client's overall health and recovery.

D. The client's blood pressure is 142/94 mm Hg: While monitoring blood pressure is important, especially in stroke patients who may have hypertension, the blood pressure reading provided does not indicate a hypertensive crisis or immediate risk to the client's safety. Therefore, it is not the priority finding compared to the risk of aspiration.