A nurse is providing education to a client who is scheduled for a left knee arthroplasty. Which of the following statements regarding informed consent indicates client understanding of the teaching?

Choice A reason: Hypothermia increases metabolic demand in newborns, depleting glucose stores rapidly. Neonates have limited glycogen reserves, and cold stress accelerates glucose use for thermogenesis, risking hypoglycemia. This is critical in nurseries, as thermoregulation is essential to prevent metabolic imbalances in vulnerable infants.
Choice B reason: Thrombocytopenia, low platelet count, affects clotting, not glucose metabolism. It may occur in sepsis but does not directly cause hypoglycemia. Glucose regulation depends on liver function and insulin balance, not platelets, making this irrelevant to hypoglycemia risk in newborns.
Choice C reason: Prematurity heightens hypoglycemia risk due to immature liver glycogen stores and limited gluconeogenesis. Preterm infants have high metabolic demands and low reserves, increasing susceptibility to low blood glucose, necessitating close monitoring and early feeding to stabilize glucose levels.
Choice D reason: Anemia, low red blood cell count, impacts oxygen delivery but not glucose metabolism directly. Severe anemia may increase metabolic stress, but it is not a primary hypoglycemia cause. Glucose regulation relies on hepatic and insulin functions, not hematologic status, in newborns.
Choice E reason: Maternal diabetes causes fetal hyperinsulinemia from maternal hyperglycemia, leading to neonatal hypoglycemia post-birth. Excess insulin depletes glucose stores after umbilical cord clamping, as maternal glucose supply ceases, making this a critical risk factor requiring vigilant monitoring in newborns.

Choice A reason: Telling the daughter not to worry dismisses her emotional concerns and does not facilitate open communication. Addressing fears about a loved one’s death requires empathy and discussion to process grief and understand hospice care, which focuses on comfort. This response is inappropriate, as it avoids addressing the daughter’s needs.
Choice B reason: Acknowledging the daughter’s concerns about her mother’s death and inviting discussion is therapeutic. It validates her emotions, encouraging open dialogue about grief, hospice care, and end-of-life expectations. This approach supports psychological coping, aligns with palliative care principles, and helps the daughter prepare for her mother’s transition, making it appropriate.
Choice C reason: Discussing the mother’s cancer and its implications helps the daughter understand the disease progression and hospice care’s role in symptom management. This fosters informed communication, addressing fears and clarifying expectations. It supports emotional preparation for end-of-life discussions, making this response appropriate for facilitating understanding and coping.
Choice D reason: Encouraging the daughter to avoid thinking about dying dismisses the reality of the situation and hinders emotional processing. Hospice care involves preparing for end-of-life, and open discussions about death are therapeutic. This response is inappropriate, as it discourages necessary conversations about the mother’s condition and prognosis.