A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, "I'm tired of wasting my life; I would rather die." Which of the following statements should the nurse make?

Rationale:

A. Limit teaching sessions about the procedure to 20 min: Preschoolers have short attention spans, but 20 minutes is still too long for teaching at this developmental stage. Teaching should be concise and focused, ideally lasting only a few minutes just before the procedure.

B. Explain in simple terms how the procedure will affect the child: Preschoolers benefit from clear, age-appropriate explanations that help them understand what to expect. Using simple language and concrete terms reduces fear and builds trust with the nurse.

C. Ask the parents to wait outside the room during the procedure: Parents often provide comfort and reassurance during stressful experiences. Unless they are interfering or the child requests otherwise, their presence can help reduce the child’s anxiety.

D. Instruct the child in deep-breathing methods prior to the procedure: While relaxation techniques are helpful for older children, preschoolers may have difficulty understanding and following deep-breathing instructions. Simple distraction methods are often more effective.

Rationale:

A. Expresses pain freely and loudly: Many Chinese American clients may view overt pain expression as a loss of control or dignity. Cultural norms often encourage stoicism, and clients may underreport pain unless directly asked in a sensitive and respectful manner.

B. Prefers foods that maintain a balance of hot and cold within the body: Traditional Chinese medicine emphasizes balance, particularly of hot and cold elements, especially during the postpartum period. Clients may prefer warm foods and drinks to restore balance and promote healing after childbirth.

C. Prefers to make direct eye contact with health care personnel: In Chinese cultural contexts, direct eye contact can be considered disrespectful or confrontational, especially toward authority figures. Avoiding eye contact may be a sign of respect rather than disinterest.

D. Tends to be very expressive with gestures and body language: Chinese American clients may communicate in a more reserved and controlled manner, often minimizing the use of expressive gestures. Nonverbal communication may be subtle, requiring attentive observation.