A nurse is assisting with staff education about hand hygiene.

Which of the following instructions should the nurse include in the teaching?

A. Write the information at an 8th-grade reading level: This is a good practice. Writing at an 8th-grade reading level ensures that the brochure is understandable for a wide audience, including those with varying levels of literacy. It helps make the information clear and accessible.

B. Present information from complex to simple: This approach is not ideal. It is generally more effective to present information from simple to complex to build understanding progressively. Starting with basic concepts helps the reader grasp foundational information before moving to more detailed content.

C. Explain medical terminology using basic, one-syllable words: While using simple language is important, basic, one-syllable words might not always be appropriate for explaining medical terminology accurately. It is better to use plain language that conveys the meaning clearly, rather than overly simplifying complex terms.

D. Use a 12-point font size: Using a 12-point font size is generally appropriate and readable for most brochures. However, depending on the audience, a slightly larger font size (e.g., 14-point) may be preferable to enhance readability.

Explanation

D. Maintain the client in high-Flower’s position

Crackles in the bases of the lungs, shortness of breath, and an increased respiratory rate are signs of pulmonary congestion, which is commonly seen in heart failure. Maintaining the client in a high-Fowler's position, with the head of the bed elevated to a 45-60-degree angle, helps reduce venous return to the heart, decreases fluid accumulation in the lungs, and improves breathing comfort for the client.

The other options are not appropriate actions for the client's condition:

Instructing the client to cough every 4 hours in (option A) is not the priority action in this situation. Coughing may not effectively address the underlying cause of pulmonary congestion and may not provide immediate relief for the client.

Encouraging the client to ambulate to loosen secretions in (option B) is not the priority action in this situation. While ambulation can be beneficial for overall health, the client's symptoms of pulmonary congestion require immediate attention to improve respiratory status.

Increasing the client's intake of oral fluids in (option C) is not the priority action in this situation. While maintaining adequate hydration is important, excessive fluid intake can worsen the symptoms of heart failure and contribute to further fluid accumulation in the lungs.

Therefore, the nurse should maintain the client in high-Fowler's position (option D) to promote optimal lung function and improve breathing comfort. It is important to promptly notify the healthcare provider of the client's condition for further assessment and intervention.