A nurse is providing care to a client who is preparing to undergo surgery. The client inquires about advance directives. Which of the following statements should the nurse make?

Choice A reason: Furosemide, a diuretic, increases urine output, reducing fluid overload in heart failure. This relieves pulmonary edema, showing the drug’s effectiveness clearly.

Choice B reason: Decreased hemoglobin isn’t tied to furosemide’s action; it reflects anemia, not fluid status. It doesn’t indicate diuretic efficacy in heart failure management.

Choice C reason: Weight gain signals fluid retention, opposite furosemide’s goal. Effective diuresis reduces weight, so this suggests treatment failure, not success.

Choice D reason: Decreased BUN may occur, but it’s not a primary furosemide marker. Urine output directly measures diuretic effect, making this less indicative.

Choice A reason: Offering multiple choices overwhelms a delirious client, whose impaired cognition struggles with decisions. Scientifically, delirium reduces attention and processing, so simplifying options aids comfort, making this counterproductive to managing their acute confusional state effectively.

Choice B reason: Alternating caregivers disrupts continuity, worsening disorientation in delirium. Consistent faces aid recognition, reducing anxiety. Scientifically, familiarity stabilizes perception in acute confusion, making this detrimental to the client’s need for a predictable environment during recovery.

Choice C reason: Avoiding fears ignores emotional distress, potentially increasing agitation in delirium. Addressing concerns gently can calm. Scientifically, unaddressed anxiety exacerbates confusion, so this neglects a holistic approach needed for managing the client’s psychological state effectively.

Choice D reason: Reminding of day and time reorients the client, countering delirium’s disorientation. Frequent cues anchor perception, aiding recovery. Scientifically, this aligns with evidence-based care, as repeated orientation reduces confusion’s impact, supporting cognitive stabilization in acute delirium management.