A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)

A. Postoperative ileus and significant drainage via an NG tube are more likely to lead to electrolyte losses rather than elevated levels. Elevated magnesium levels are less common and typically associated with conditions such as renal failure or excessive magnesium intake.
B. Calcium levels can be affected by gastrointestinal losses, including drainage via an NG tube. Significant fluid loss can lead to hemoconcentration, potentially causing a relative increase in calcium levels initially. However, prolonged fluid loss can lead to overall depletion of electrolytes, including calcium.
C. When fluids are lost through the NG tube, potassium, which is an intracellular electrolyte, can be lost in large amounts. Prolonged drainage can lead to hypokalemia (decreased potassium levels), which can result in muscle weakness, cardiac dysrhythmias, and other serious complications.
D. Elevated sodium levels (hypernatremia) are more commonly associated with dehydration or excessive sodium intake rather than drainage via an NG tube. In this scenario, sodium levels are less likely to be affected compared to potassium.

A. A back massage (A) can be soothing and may help with circulation, but it's not typically a priority immediately postoperative.
B. Teaching relaxation techniques such as deep breathing exercises, guided imagery, or progressive muscle relaxation can help the client manage pain, reduce anxiety, and promote faster recovery. These techniques empower the client to actively participate in their comfort and recovery process.

C. Postoperative clients are at risk of developing respiratory complications such as atelectasis (partial lung collapse) due to shallow breathing. Coughing and deep breathing exercises help to expand lung volume, clear secretions, and prevent respiratory complications. It's important to encourage and assist the client in performing these exercises regularly.
D. Encouraging the client to turn every 4 hours helps prevent pressure ulcers and promotes good circulation, but turning might be more frequent depending on the surgery and the client's condition.
E. Pain management is crucial for postoperative comfort and recovery. Administering analgesics as needed helps to control pain effectively, which is essential for the client to participate in activities such as deep breathing, coughing, and moving, thereby reducing the risk of complications.