A nurse is providing discharge teaching for a client who has a new implantable cardioverter defibrillator (ICD). Which of the following client statements demonstrates understanding of the teaching?

A. Intellectual impairment

- The correct answer is ID.

- Intellectual impairment is a core feature of ID, which is characterized by significant limitations in intellectual functioning and adaptive behavior that are present before age 18.

- Intellectual impairment can sometimes be a feature of ADHD, but it's not a defining characteristic. ADHD, or Attention Deficit Hyperactivity Disorder, primarily involves difficulties with attention, hyperactivity, and impulsivity. However, some individuals with ADHD may also experience challenges with certain aspects of cognitive function, such as executive function, working memory, and processing speed. These difficulties can sometimes be mistaken for intellectual impairment, but it's important to note that ADHD itself does not necessarily indicate lower intelligence. ADHD is a neurodevelopmental disorder that affects individuals differently, and many people with ADHD have average or above-average intelligence..

B. Losing necessary things

- The correct answer is ADHD.

- Losing necessary things is a common symptom of ADHD, especially in the inattentive subtype. Children with ADHD may have difficulty organizing their belongings, remembering where they put them, or keeping track of them.

- Losing necessary things is not a specific indicator of ID, although children with ID may also have difficulties with memory and organization.

C. Impaired language skills

- The correct answer is ID.

- Impaired language skills are often associated with ID, as language development depends on cognitive abilities and social interactions. Children with ID may have delays or difficulties in acquiring, understanding, or using spoken or written language.

- Impaired language skills are not a typical feature of ADHD, although some children with ADHD may have coexisting language disorders or learning disabilities.

D. Hyperreactivity to sensory input

- The correct answer is ADHD.

- Hyperreactivity to sensory input is a possible manifestation of ADHD, especially in the hyperactive-impulsive subtype. Children with ADHD may be easily distracted by external stimuli, such as noises, lights, or movements, or may seek sensory stimulation by fidgeting, touching, or moving around.

- Hyperreactivity to sensory input is not a characteristic of ID, although some children with ID may also have sensory processing issues or autism spectrum disorder.

E. Interrupting others

- The correct answer is ADHD.

- Interrupting others is another common sign of ADHD, especially in the hyperactive-impulsive subtype. Children with ADHD may have difficulty waiting their turn, following social rules, or respecting others' boundaries. They may blurt out answers, comments, or questions without thinking or listening.

- Interrupting others is not a typical behavior of children with ID, although some children with ID may also have social skill deficits or communication problems.

• Urinary output is an important indicator of fluid balance and kidney function. After delivery, a woman may experience increased urinary output due to the loss of excess fluid that was retained during pregnancy and the diuretic effect of oxytocin, which is released during breastfeeding. This is a normal and expected finding in the postpartum period.
• However, increased urinary output may also be a sign of urinary retention, which is the inability to empty the bladder completely. Urinary retention can occur due to trauma to the bladder or urethra during delivery, swelling or hematoma of the perineum, epidural anesthesia, or decreased bladder sensation.Urinary retention can lead to complications such as infection, bladder distension, or postpartum hemorrhage.
• Therefore, when a woman who delivered a normal newborn 24 hours ago reports that she seems to be urinating every hour or so, the practical nurse (PN) should measure the next voiding, then palpate the client's bladder. This will help to assess the amount and quality of urine and the presence or absence of bladder distension. A normal urine output is about 30 ml per hour, and a normal bladder should feel soft and empty after voiding. If the urine output is low or high, or if the bladder feels firm or full after voiding, the PN should report these findings to the primary healthcare provider for further evaluation and intervention.

Therefore, option B is the correct answer, while options A, C, and D are incorrect.

Option A is incorrect because catheterizing the client for residual urine volume is an invasive procedure that should only be done if indicated by the primary healthcare provider.

Option C is incorrect because evaluating for normal involution and massaging the fundus are related to uterine function, not urinary function.

Option D is incorrect because obtaining a specimen for urine culture and sensitivity is not necessary unless there are signs of infection, such as fever, dysuria, or foul-smelling urine.