A nurse is caring for a client who has a prescription for diltiazem. The nurse measures the client's vital signs and notes that the client's apical heart rate is 49/min. The nurse should prepare to administer which of the following medications?

(A) Develop client-specific goals and outcomes: While this is an important step in the nursing process, it is not the first step. Before developing goals and outcomes, the nurse needs to understand the client’s situation, which in this case involves determining the nature of the client’s grief.

(B) Incorporate the treatment into the client’s care: Incorporating treatment into the client’s care is part of the implementation phase of the nursing process. Before this step, the nurse needs to assess the client’s condition and plan the care, which includes understanding the nature of the client’s grief.

(C) Determine whether coping strategies were successful: Determining the success of coping strategies is part of the evaluation phase of the nursing process. This is typically done after the implementation of care and treatment. It is not the first step in caring for a client experiencing grief.

(D) Establish whether the client’s grieving is healthy or complicated: This is the most appropriate answer. The first step in the nursing process is assessment. For a client experiencing grief, this would involve establishing whether the client’s grieving is healthy (a normal response to loss) or complicated (prolonged or more intense grief that may require additional support or intervention). This understanding will guide the subsequent steps of the nursing process, including planning care and setting goals.

(A) "A heating pad will be used on the operative site to help reduce pain.":
Using a heating pad on the operative site is generally not recommended post-surgery, as it can increase bleeding and swelling. Cold therapy is usually preferred to help reduce pain and inflammation.

(B) "You will use a continuous passive motion (CPM) machine several times a day.":
Continuous passive motion machines are typically used after knee replacement surgeries, not hip replacement surgeries. Therefore, this statement would not be accurate for a total hip replacement.

(C) "Expect to remain in bed for at least the first 24 hours.":
Early mobilization is crucial after hip replacement surgery to prevent complications such as deep vein thrombosis and to promote recovery. Patients are usually encouraged to get out of bed and start moving with assistance as soon as possible, often within the first 24 hours.

(D) "You will use a special soap to shower with the evening before your surgery.":
Using a special antiseptic soap before surgery is a common preoperative instruction to help reduce the risk of infection. This statement is correct and should be included in the preoperative teaching.