A nurse is providing discharge teaching about home care of a surgical incision to a client who speaks a different language from the nurse.
The nurse is communicating with the client using an interpreter. Which of the following actions should the nurse take?

This statement indicates that the client understands the importance of reducing swelling and inflammation in the affected hand after carpal tunnel surgery.
Elevation promotes venous return and prevents fluid accumulation in the tissues.

Choice A is wrong because applying heat for the first 24 hours can increase blood flow and swelling in the hand, which can cause more pain and delay healing. Ice packs are recommended for the first 24 to 48 hours to reduce inflammation.

Choice B is wrong because the client should not avoid using the affected hand for 4 to 6 weeks, as this can lead to stiffness, muscle atrophy, and decreased range of motion. The client should move the fingers periodically and perform gentle exercises as prescribed by the surgeon or physical therapist.
Choice C is wrong because numbness and tingling in the hand are signs of nerve compression, which is the main cause of carpal tunnel syndrome.
The client should expect these symptoms to improve or resolve after surgery, not persist or worsen. If the client experiences numbness and tingling after surgery, they should report it to the surgeon as it may indicate a complication such as nerve injury or hematoma.
Normal ranges for grip strength, pinch strength, and key pinch strength vary depending on age, sex, and hand dominance. However, a general reference for grip strength is 20 to 40 kg for men and 15 to 30 kg for women. For pinch strength, it is 6 to 12 kg for men and 5 to 10 kg for women. For key pinch strength, it is 4 to 8 kg for men and 3 to 7 kg for women.
These values may be lower in older adults or people with chronic conditions.
The client should expect some loss of strength in the affected hand after surgery, but it should gradually improve with rehabilitation.

The correct answer is choice b. “I can start the medication 30 minutes earlier.”.

Choice A rationale:

Adjusting the time and schedule for convenience is not appropriate for medications like vancomycin, which require precise timing to maintain therapeutic levels and avoid resistance.

Choice B rationale:

Starting the medication 30 minutes earlier is a reasonable adjustment that maintains the medication’s effectiveness and safety.

Choice C rationale:

Administering the medication up to 2 hours after the usual schedule time is incorrect because it could lead to subtherapeutic levels and reduced effectiveness.

Choice D rationale:

Infusing the medication at a faster rate is unsafe as it increases the risk of adverse reactions, such as "red man syndrome".