A nurse is assisting with teaching a client who has obstructive sleep apnea (OSA) about continuous positive airway pressure (CPAP). Which of the following instructions should the nurse include?

Choice C rationale:
The most crucial instruction regarding the safety of fentanyl patches is to apply them as directed by the primary care provider. Fentanyl is a potent opioid medication, and its misuse or improper application can lead to serious health risks, including overdose. Therefore, following the prescriber's instructions is of utmost importance to ensure the patient's safety.
Choice A rationale:
Storing fentanyl patches in a locked cabinet is a good practice to prevent unauthorized access and to keep them out of reach of children or individuals who should not have access to the medication. However, it is not the most critical safety instruction. Proper application and usage are more important.
Choice B rationale:
While preparing the skin by cleaning with an antiseptic scrub solution is a necessary step when applying a transdermal medication like a fentanyl patch, it is not the most critical safety instruction. It is a standard part of the application process but does not address the overarching safety concerns related to fentanyl use.
Choice D rationale:
Using fentanyl patches as needed for breakthrough pain without clear guidance from a healthcare provider is not a safe practice. Fentanyl is a potent medication with a high risk of overdose, and its use should always be closely monitored and directed by a healthcare professional. Self-adjusting the dosage without medical supervision can lead to serious safety issues.

Choice A rationale:
IM injections of pain medication may be contraindicated for patients who have small, poorly developed muscles. The rationale for this is that IM injections require adequate muscle mass to ensure proper absorption and distribution of the medication. If a patient has small, poorly developed muscles, the injection may not be as effective, and there's a risk of improper medication delivery, which can lead to reduced pain relief and potential complications.
Choice B rationale:
IM injections are not primarily contraindicated for patients based on their cognitive abilities. However, the patient's cognitive abilities may affect their ability to understand and follow instructions related to the injection process. It's essential for healthcare providers to ensure that the patient comprehends the procedure and can cooperate. Patients with cognitive impairments may require additional assistance or alternative methods of pain management, but it's not a direct contraindication to IM injections.
Choice C rationale:
Needing short-term pain management is not a contraindication for IM injections of pain medication. IM injections can be suitable for short-term pain relief, as they can provide relatively rapid and effective pain control. The choice of pain management method should depend on the specific circumstances and the patient's condition, but the duration of pain management needed is not a direct contraindication to IM injections.
Choice D rationale:
Having multiple drug allergies can be a concern when considering IM injections of pain medication, but it is not a direct contraindication. The healthcare provider should carefully assess the patient's allergies and select a medication that is safe and appropriate for the individual. In some cases, alternative routes of administration may be considered to avoid allergenic reactions. However, having multiple drug allergies alone does not necessarily contraindicate IM injections.