A nurse is providing discharge teaching to a client who will be using a cane to maintain mobility at home following a left knee arthroplasty. Which of the following statements by the client indicates an understanding of the safe use of a cane?

Choice A rationale:

Chronic grief is characterized by a prolonged and ongoing sense of loss that doesn't seem to improve with time. It doesn't directly relate to maladaptive coping, which the client in the scenario is exhibiting. Chronic grief may involve a persistent yearning or sadness for the deceased, but it doesn't necessarily involve maladaptive coping strategies.

Choice B rationale:

The client's use of alcohol and controlled substances to cope with the death of their partner indicates an exaggerated grief response. Exaggerated grief involves an intense and prolonged expression of grief that may be accompanied by excessive, intense emotions and behaviors. The client's use of substances to cope is an unhealthy and maladaptive way of dealing with their grief.

Choice C rationale:

Delayed grief refers to a situation where the emotional response to a loss is significantly postponed, often resulting in a delayed and intense reaction later on. It doesn't necessarily involve maladaptive coping, as seen in the client's case.

Choice D rationale:

Masked grief occurs when the grieving person's behavior and emotional responses are influenced by the loss but not recognized as being related to it. This can lead to various physical or psychological symptoms that mask the true underlying cause, the grief. While maladaptive coping can sometimes be seen in masked grief, it doesn't directly correlate with the client's substance use in this scenario.

Choice A rationale:

Encouraging the client to ambulate is not appropriate when the client has a high fever of 40°C (104°F). Ambulation requires physical exertion and can potentially worsen the client's condition, especially when they are already experiencing discomfort due to the fever.

Choice B rationale:

Giving the client a cold sponge bath might seem like a logical approach to reduce fever; however, it is not the most effective and safest method. Cold water can cause vasoconstriction and shivering, potentially increasing the body's metabolic demands and raising the temperature further. Additionally, sudden temperature changes can be uncomfortable and may not provide sustained fever reduction.

Choice C rationale:

Administering antipyretics as prescribed is the correct choice. Antipyretic medications, such as acetaminophen or ibuprofen, work to lower fever by acting on the hypothalamus, the body's temperature-regulating center. By reducing fever, the body's metabolic rate and oxygen consumption are decreased, which can help prevent complications associated with high fever, such as dehydration and discomfort.

Choice D rationale:

Providing a cooling fan can offer some comfort, but it might not be sufficient to effectively lower the client's high fever. Fans primarily work by promoting evaporative cooling, which may not be efficient when the body temperature is significantly elevated. Additionally, relying solely on a cooling fan might delay the necessary intervention of administering antipyretic medication.