A nurse is caring for a client who has cancer and is terminally ill. The client reports feeling depressed. Which of the following statements should the nurse make?

1. Apply warm compresses to the incision site
Contraindicated
Applying warm compresses directly to the surgical site, especially in a perineal prostatectomy, could potentially increase the risk of infection or cause increased swelling in the surgical area. The incision site is still healing, and local heat could increase blood flow, which might lead to complications like bleeding or infection.
2. Administer enema to relieve constipation

Anticipated
The client reports abdominal cramping and small, hard, painful bowel movements, which are signs of constipation. Enemas are commonly used to relieve constipation and to prevent straining that could stress the perineal surgical site or cause hemorrhoidal irritation. The use of an enema is appropriate in this case to help alleviate the client's symptoms.
3. Irrigate indwelling urinary catheter with 50 mL of normal saline

Anticipated
After prostatectomy, clients often have an indwelling urinary catheter for urinary drainage. Irrigating the catheter can help prevent clogging and maintain proper drainage. Normal saline is a sterile solution and would help ensure the catheter is patent, which is particularly important for preventing urinary retention or infection.
4. Place a blanket roll under the client's knees while in bed

Anticipated
Placing a blanket roll under the client’s knees helps to maintain a comfortable position, which can promote venous return and reduce pressure on the perineum and lower back. This position is also beneficial for alleviating perineal pain after prostate surgery.
5. Maintain bed rest for 2 days postoperatively

Contraindicated
The client has already demonstrated the ability to ambulate independently and transfer out of bed to a chair. Prolonged bed rest after surgery is generally discouraged unless there are specific complications (e.g., excessive bleeding, infection). Early ambulation is encouraged to prevent DVT, promote circulation, and prevent complications such as atelectasis and constipation.

A. The nurse should not make a judgment about the client’s benefit from reviewing their notes; the
client has the right to access their records.
B. Psychotherapy notes are protected and are not included in the general medical record. The nurse should inform the client of this policy.
C. Asking if the client is happy with treatment could be perceived as dismissive and irrelevant to the
client’s right to access their records.
D. The nurse should not question the client’s motivation but rather provide accurate information about the process for obtaining their records.