A nurse is caring for a postoperative client and observes evisceration of the abdominal surgical wound. After covering the wound with a sterile, saline-soaked dressing, which of the following actions should the nurse take?

Choice A rationale:

Before initiating teaching for a client with a new diagnosis of type 2 diabetes mellitus, it is essential to identify the client's learning needs. This involves assessing what the client already knows about the condition, their level of understanding, and any specific areas of concern or interest. By establishing the learning needs, the nurse can tailor the teaching plan to address the client's individual requirements, thereby enhancing the effectiveness of the education provided.

Choice B rationale:

While determining the client's literacy level (Choice B) is important, it might not take precedence over understanding the client's learning needs. However, assessing literacy is still relevant because it helps the nurse adapt the teaching materials and language used to ensure the client comprehends the information.

Choice C rationale:

Evaluating the client's readiness for learning (Choice C) is significant, but it should ideally follow the identification of learning needs. Readiness for learning pertains to the client's emotional and psychological state, which can impact their ability to absorb new information. While essential, it should not be the initial step in planning teaching.

Choice D rationale:

Verifying the client's computer access (Choice D) is not directly related to the immediate planning of teaching for a new diagnosis of type 2 diabetes mellitus. While technology and access to online resources can enhance learning, this consideration is secondary to understanding the client's knowledge gaps and preferred learning style.

Choice E rationale:

Identifying the client's learning style (Choice E) is valuable in customizing the teaching approach, but it comes after establishing learning needs. Learning styles, such as visual, auditory, or kinesthetic, can influence the most effective way to present information. However, without first determining what the client needs to know, tailoring the teaching style might not yield optimal results.

Choice A rationale:

Providing a cup of hot chocolate prior to bedtime is not a suitable intervention for a client reporting difficulty sleeping. Hot chocolate contains caffeine, which can act as a stimulant and interfere with sleep. Caffeine is known to disrupt sleep patterns and should be avoided close to bedtime.

Choice B rationale:

Scheduling exercise activities at least 3 hours before bedtime is the correct intervention for a client experiencing difficulty sleeping. Regular exercise promotes better sleep quality by helping to regulate the sleep-wake cycle and improve sleep duration. However, exercising too close to bedtime can have a stimulating effect, making it harder for the client to fall asleep. By scheduling exercise activities earlier in the day, the client's body will have sufficient time to wind down before bedtime, leading to improved sleep.

Choice C rationale:

Keeping soft music playing at bedtime and throughout the night might not be effective for everyone. While soft music can create a calming environment and help some individuals relax, it may not address the underlying causes of the client's difficulty sleeping. Additionally, some people might find background noise disruptive to their sleep. Therefore, this option might not be as effective as adjusting the timing of exercise.

Choice D rationale:

Scheduling mealtime 2 hours before bedtime is generally a good practice, but it might not directly address the client's reported difficulty sleeping. Consuming heavy or spicy meals close to bedtime can cause discomfort and indigestion, which might interfere with sleep. However, adjusting mealtime alone might not be sufficient to resolve the client's sleep issues, especially if other factors are contributing to their insomnia.