A nurse is preparing for a home visit with a client who is postoperative following an above-the-knee amputation. Which of the following questions should the nurse plan to ask first?

A. Initiate a 24-hr urine collection for a client who has end-stage kidney disease:

While a 24-hour urine collection is important for assessing kidney function, it is not an urgent task and can be scheduled at a later time without compromising the client's immediate well-being.

B. Change the dressing for a client who has a decubitus ulcer:

Changing the dressing for a decubitus ulcer is important for wound care, but it is not as urgent as addressing respiratory distress in a client with COPD.

C. Administer an antibiotic for a client who has methicillin-resistant Staphylococcus aureus:

Administering an antibiotic for a client with a methicillin-resistant Staphylococcus aureus (MRSA) infection is important, but it is not as immediately critical as ensuring adequate oxygenation in a client with COPD. Respiratory issues take precedence in the hierarchy of priorities.

D. Initiate oxygen therapy via nasal cannula for a client who has COPD.

The priority should be given to tasks that address immediate threats to the client's well-being or safety. In this scenario, initiating oxygen therapy for a client with COPD is a priority because it addresses respiratory distress and hypoxia, which are critical concerns in individuals with COPD. Respiratory interventions take precedence to ensure adequate oxygenation.

A. "Maybe you should wait to have the procedure."

This response may come across as directive and could potentially influence the client's decision. It does not encourage the client to express their feelings or concerns but suggests a specific course of action.

B. "This is a common feeling for clients to have before the procedure."

While it's true that many clients may experience conflicted feelings before undergoing certain procedures, this response is somewhat dismissive. It does not invite the client to explore their specific concerns and may not address the individual nature of the client's feelings.

C. Share more with me about your concerns related to the procedure.

This response encourages the client to express their concerns and provides an opportunity for the nurse to understand the specific issues causing the conflict. It demonstrates empathy and openness, fostering a therapeutic nurse-client relationship. By inviting the client to share more, the nurse can gain insight into the client's emotional and psychological concerns about the tubal ligation.

D. "Why are you concerned about the procedure?"

While this question is an attempt to understand the client's concerns, it may be perceived as too direct or confrontational. The wording might make the client feel defensive or pressured to justify their feelings. The more open-ended phrasing in option C is generally more conducive to therapeutic communication.