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: Encouraging open communication fosters dialogue, allowing nurses to resolve conflicts directly. This reduces tension and improves teamwork by addressing interpersonal issues, aligning with psychological principles of conflict resolution. Effective communication mitigates misunderstandings, enhancing collaboration in high-stress healthcare environments.
Choice B reason: Assigning an external mediator may help but is premature without trying internal resolution. Encouraging team dialogue leverages existing relationships, fostering cohesion. External mediators may not address unit-specific dynamics, making internal communication a more effective first step in resolving nurse conflicts.
Choice C reason: Mandatory team-building exercises may improve morale but do not directly resolve specific conflicts. Forcing participation can increase resentment if issues persist. Communication-based strategies target root causes, making them more effective for conflict resolution in healthcare teams compared to generic team-building.
Choice D reason: Reassigning nurses to different shifts avoids conflict but disrupts workflow and patient care continuity. It fails to address underlying issues, allowing tensions to persist. Communication-focused approaches promote resolution, maintaining team integrity and collaboration in healthcare settings, unlike reassignment.

Choice A reason: Hypernatremia is unlikely with 0.45% sodium chloride, a hypotonic solution that dilutes serum sodium. Over-infusion risks hyponatremia, not high sodium levels. Monitoring for hypernatremia is inappropriate, as the solution’s low sodium content does not contribute to elevated sodium in fluid therapy.
Choice B reason: Assessing for fluid overload is essential, as 0.45% sodium chloride, being hypotonic, can cause water to shift into cells, risking pulmonary or cerebral edema. This is critical in clients with renal or cardiac issues, where monitoring for dyspnea or swelling ensures safe fluid administration.
Choice C reason: Hypoglycemia is not directly linked to 0.45% sodium chloride, which affects fluid and electrolytes, not glucose. Fluid shifts may indirectly stress metabolism, but hypoglycemia relates to fasting or insulin issues, making this an inappropriate focus for monitoring in this fluid therapy context.
Choice D reason: Dehydration is unlikely, as 0.45% sodium chloride provides free water, promoting hydration. It corrects hypernatremia or replaces fluid losses. Evaluating for dehydration is unnecessary unless infusion is inadequate or losses persist, which is not indicated in the context of this hypotonic solution.