A nurse is caring for a postoperative client following a perineal prostatectomy.

Exhibits

For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

Potential Order:.

This statement shows respect for the client’s interest in alternative therapies and offers guidance on how to choose a reliable and qualified provider. Alternative therapies can provide some benefits for people with rheumatoid arthritis, such as reducing pain, inflammation, and stiffness, but they should be used as a complement to conventional treatments and not as a substitute.
Choice B is wrong because it implies that the client has no role in deciding their own treatment plan and that alternative therapies are not worth considering.
This may discourage the client from sharing their preferences and concerns with the provider.
Choice C is wrong because it suggests that online support groups are a reliable source of information about alternative remedies, which may not be true.
Online sources may contain inaccurate, misleading, or harmful information that could jeopardize the client’s health and safety.
Choice D is wrong because it encourages the client to try any therapy that fits their personal belief system, without considering the evidence, effectiveness, or potential risks of such therapies. Some alternative therapies may interact with medications, cause side effects, or worsen the condition.
Normal ranges for rheumatoid arthritis are not applicable to this question, as it is not asking about laboratory values or disease activity measures. However, some common tests used to diagnose and monitor rheumatoid arthritis include erythrocyte sedimentation rate (ESR), C- reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and joint ultrasound or X-ray.
The normal ranges for these tests may vary depending on the laboratory and the method used.

The correct answer is Choice D, "We can provide a copy of your records, but the therapist's notes are not included."

Rationale for Choice A:

• Puts the client on the defensive:Asking "Why are you interested in seeing your therapist's notes?" can make the client feel like they need to justify their request,potentially leading to defensiveness or withdrawal.
• May not uncover true motivation:The client may not feel comfortable revealing their true reasons for wanting to see the notes,and this approach could hinder open communication.
• Undermines client autonomy:It's important to respect the client's right to access their own information,even if it's not always beneficial.Questioning their motives could make them feel less empowered in their treatment.

Rationale for Choice B:

• Paternalistic and dismissive:Saying "I don't think you will benefit from reviewing your therapist's notes right now" assumes that the nurse knows what's best for the client without exploring their perspective.
• Discourages open communication:It shuts down conversation and may prevent the client from expressing their concerns or needs.
• Could damage therapeutic relationship:By dismissing the client's request,the nurse risks eroding trust and rapport,which are essential for effective therapy.

Rationale for Choice C:

• Assumes dissatisfaction with treatment:Asking "Are you not happy with your treatment?" immediately focuses on potential problems rather than understanding the client's motivations.
• May not be accurate:The client's request may not stem from dissatisfaction with treatment but rather from curiosity,a desire for control,or other reasons.
• Could create unnecessary anxiety:Raising concerns about treatment satisfaction without proper exploration could create anxiety or doubts in the client's mind.

Rationale for Choice D:

• Clear and informative:It directly addresses the client's request while providing accurate information about the availability of records.
• Protects therapist's notes:It upholds the therapist's right to maintain confidentiality of their thought processes and clinical impressions.
• Offers alternative solutions:It suggests that the client can access other parts of their record,potentially addressing their underlying need for information.
• Professional and respectful:It maintains professional boundaries and respects the client's right to information without disclosing protected notes.