A nurse is providing education to a client who is reviewing a consent form for a surgical procedure. Which of the following statements by the client indicates an understanding of the consent?

Choice A reason: A quiet environment reduces sensory stimulation, which can elevate intracranial pressure (ICP) by increasing cerebral blood flow. Minimizing noise helps stabilize intracranial dynamics, preventing exacerbation of brain injury. This intervention supports neurological stability, critical in traumatic brain injury management to avoid secondary damage.
Choice B reason: Monitoring vital signs every 8 hours is inadequate for increased ICP, which requires frequent checks (e.g., every 1-2 hours). Changes in blood pressure or respiration signal worsening ICP, risking herniation. Infrequent monitoring delays detection of neurological deterioration, compromising timely intervention in brain injury.
Choice C reason: Coughing and deep breathing increase intrathoracic pressure, elevating ICP by impeding cerebral venous return. This is contraindicated in traumatic brain injury, as it risks worsening cerebral edema or causing herniation, potentially leading to severe neurological damage or fatal outcomes in affected clients.
Choice D reason: A 30-degree head-of-bed elevation promotes cerebral venous drainage, reducing ICP. This position optimizes cerebral perfusion pressure, minimizing venous congestion in traumatic brain injury. It is a critical intervention to prevent secondary brain injury, supporting neurological recovery by stabilizing intracranial dynamics effectively.
Choice E reason: Stool softeners prevent straining during bowel movements, which increases intrathoracic and intracranial pressure. In traumatic brain injury, straining risks exacerbating ICP, potentially causing herniation. This intervention ensures smoother bowel movements, maintaining ICP stability and supporting safe management of brain injury.

Choice A reason: Using gauze to cover an infant’s IV site obscures visualization, delaying detection of infiltration or infection. Transparent dressings are preferred, as infants’ small veins are prone to complications. Gauze increases risk by hiding signs like swelling, critical for early intervention in pediatric IV management.
Choice B reason: Monitoring an IV site every 8 hours is inadequate for infants, who need hourly checks due to small vein fragility and high infiltration risk. Frequent assessment detects complications like phlebitis or extravasation early, ensuring vascular integrity and preventing tissue damage in pediatric patients.
Choice C reason: Inserting an IV in the foot is less preferred, as scalp or hand veins are more accessible and stable in infants. Foot IVs risk dislodgement from movement and may impair circulation, increasing complications like tissue damage, making this a suboptimal choice for IV placement.
Choice D reason: A 24-gauge catheter is ideal for infants, as their small veins require smaller needles to minimize trauma and infiltration. This size ensures adequate fluid or medication delivery while reducing vascular damage, aligning with pediatric IV guidelines for safe and effective venous access.