A nurse is assisting with the admission of a client who is about to have elective surgery. The client tells the nurse she feels anxious. Which of the following responses should the nurse make?

A. Pneumococcal vaccine → Not having it increases risk, but the option itself (“Pneumococcal vaccine”) is misleading; risk comes from lack of vaccine, not its presence.

B. Level of consciousness → Client is lethargic and has difficulty answering questions, which can increase risk of aspiration and reduce effective airway clearance.

C. Influenza vaccine → Similarly, not getting the vaccine is a risk, but the option is phrased as “Influenza vaccine,” which is protective, not a risk factor.

D. Health history → Lack of pneumococcal and influenza vaccinations increases susceptibility to respiratory infections.

E. Fluid intake → Client reports reduced fluid intake, leading to thickened secretions, impaired mucociliary clearance, and higher risk of pneumonia.

F. Age → Middle-aged and older adults are at higher risk for pneumonia due to decreased physiologic reserve.

G. Smoking history → Smoking history is incorrect. While a history of smoking, or exposure to second-hand smoke, increases a client’s risk of contracting community-acquired pneumonia, the client reports no smoking history.

A. Alcohol abuse disorder can lead to dehydration and electrolyte imbalances but is not directly linked to low potassium levels.
B. NG tube to gastric suction can lead to potassium loss through gastric secretions, potentially causing hypokalemia.
C. Drinking large amounts of water is not typically associated with low potassium levels; excessive water intake can dilute electrolytes but is less likely to cause hypokalemia.
D. Spironolactone is a potassium-sparing diuretic that can actually increase potassium levels, making it less likely to cause hypokalemia.